Oral
Answers to
Questions

Scotland

The Secretary of State was asked—

Impact of Leaving the EU

Marion Fellows: Whether he has made a recent assessment of the impact of the UK leaving the European Union on Scotland.

Angela Crawley: Whether he has made a recent assessment of the impact of the UK leaving the European Union on Scotland.

Martyn Day: Whether he has made a recent assessment of the impact of the UK leaving the European Union on Scotland.

Alyn Smith: Whether he has made a recent assessment of the impact of the UK leaving the European Union on Scotland.

Douglas Chapman: Whether he has made a recent assessment of the impact of the UK leaving the European Union on Scotland.

Stuart McDonald: Whether he has made a recent assessment of the impact of the UK leaving the European Union on Scotland.

Alister Jack: There are many benefits of leaving the EU for Scotland. They include: the ability to agree new trade deals and strategic partnerships, controlling our borders, ensuring that regulation fits the needs of the United Kingdom, control of our fishing waters and the ability to improve the competitiveness of our economy while maintaining high standards.

Marion Fellows: Statistics from His Majesty’s Revenue and Customs show that Scottish exports have plummeted by £2.2 billion over the two years since Brexit, which has already cost Scotland’s economy around £4 billion. The consequences of Brexit have been invariably harmful. What is the Secretary of State for Scotland doing to protect Scotland from this Tory-imposed act of economic self-harm?

Alister Jack: The hon. Lady quotes statistics for the two years following Brexit, but those of course are two years where we had other factors to take into account, not only covid and many lockdowns across Europe, but the illegal war in Ukraine. In the first two quarters of 2022, the United Kingdom did more trade with the European Union than it did in any quarter when we were members of the European Union.

Angela Crawley: Brexit has cost the UK £40 billion a year in tax revenue. That would be enough to fill the black hole caused by the Tory mini-Budget, along with yet another round of Tory austerity. Scotland did not vote for Brexit, for this Government, the last one or the one before that, so does the Secretary of State think it is right that Scotland should suffer due to his party’s extreme Brexit ideology?

Alister Jack: This Government respect democracy. We respect the outcome of referendums. There was a referendum in 2014 on Scottish independence. We respected the result; the Scottish National party has not. In 2016, the United Kingdom, which we are all part of, voted to leave the European Union, and we delivered on that.

Martyn Day: A report from the Nuffield Trust has found that Brexit is worsening NHS workforce challenges, particularly the recruitment of specialities. Trade barriers have driven up costs and made shortages of medicines and medical devices worse in the UK than in Europe. Why should the people of Scotland suffer worse health outcomes as a consequence of a Brexit they did not vote for?

Alister Jack: I would say that the people of Scotland are suffering worse health outcomes because of the incompetence of the Scottish Government to run the health system. Regarding NHS recruitment, I further add that we have a points-based system. It creates flexibility and allows us to deal with the skills gap, and a points-based system was the former policy of the Scottish National party.

Alyn Smith: Brexit has demonstrably been a disaster for the Scottish fisheries sector. The catchers and the processors are having a dreadful time, but even these trading arrangements are due to end in 2026 under the trade and co-operation agreement. What thought has the Secretary of State given to the future trading arrangements after 2026, or will it be just another betrayal?

Alister Jack: We have taken control of our waters. We have left the hated common fisheries policy. We have seen our quota increase by 30,000 tonnes this year in negotiations. We are going to take full control of our waters at the end of the five-year period, and with the other things we are putting in place to support industry, we will increase the processing business, as well.

David Duguid: It is interesting to follow the previous question. Does my right hon. Friend agree that additional UK fishing opportunities totalling about £750 million—that is on top of the TCA agreement—have been secured in recent end-of-year negotiations? Does he agree with me and the Scottish Fishermen’s Federation that Scottish industry and Scottish  Government Ministers and officials have a stronger voice in the annual negotiations since leaving the EU, and the hated common fisheries policy, than ever they would have when we were still in the EU?

Alister Jack: My hon. Friend is a great advocate for the fishing industry, and I agree with everything he says. We have a stronger voice. We have increased our tonnage by 30,000 tonnes, and we will continue to increase it. Everything he does to support that industry is laudable.

Douglas Chapman: This Government seem hellbent on destroying the Scottish seafood sector. Some £60 million has been spent on additional Brexit paperwork alone, while export delays and exclusions undermine our export potential. What has happened to the Brexit sea of opportunity that was promised, and does the Minister accept the assessment of the Scottish White Fish Producers Association that Brexit has
“failed to deliver any benefits”
of a coastal state?

Alister Jack: I do not accept that assessment. Certain sectors of the fishing industry have made much progress and seen many benefits. On the processing sector, we are looking at what the shortage occupation list could do to help the sector and at further investment in the north-east. I am confident that there is a sea of opportunity, which we will see over the five-year period, and that, at the end of those five years, the fishing sector will not be jumping up and down saying, “Let’s get back into the common fisheries policy.”

Stuart McDonald: The brilliant EU citizens who contribute to Scotland’s communities, public services and economy include more than 100,000 people who currently have the precarious pre-settled status. The High Court in England recently ruled that the requirement of a further application to preserve their rights here was unlawful and contrary to the withdrawal treaty. Will the Secretary of State agree that the judgment is welcome and should be respected—providing, as it does, security for those EU citizens and protecting their ongoing contributions to Scotland and the UK?

Alister Jack: We welcome all EU citizens with settled status and think it is absolutely right that those systems are in place. If the hon. Gentleman has any further questions regarding the matter, I suggest he raise the matter at Home Office questions. I think the system that we have is working and is fair.

Kevin Foster: When conducting his assessment, did the Secretary of State include figures for the impact of implementing the Schengen borders code between Scotland and England, including the requirements for border infrastructure, that would be required if we listened to the SNP and implemented its policies?

Alister Jack: My hon. Friend makes a good point. There is not just the issue of freedom of movement of people across the United Kingdom, but the fact that while 20% of Scotland’s trade is with the EU and 20% with the rest of the world, 60% is with the rest of the United Kingdom.

Lindsay Hoyle: I call the SNP spokesperson.

Philippa Whitford: My colleagues have highlighted just some of the negative impacts of Brexit on individuals, businesses, universities and public services in Scotland. There simply are no real Brexit opportunities or sunlit uplands. Does it therefore come as a surprise to the Secretary of State that a poll last year showed that 69% of Scottish voters want to rejoin the EU?

Alister Jack: I welcome the hon. Lady to her new role, and thank the hon. Member for Paisley and Renfrewshire South (Mhairi Black) for her positive engagement in the role previously.
Opinion polls come and go; we have seen that. Last week, we saw that 59% of Scots want to remain in the United Kingdom—I notice that that opinion poll was not quoted. As for the benefits of Brexit, we can make our own trade deals, and we have made 71 to date. The SNP has never seen a trade deal it liked—it has never voted for a trade deal in the European Parliament or in this Parliament. There are further benefits: we have left the hated common fisheries policy; I know the hon. Member for Central Ayrshire (Dr Whitford) is very keen on the health sector, and we had an accelerated vaccine programme roll-out; we had a fast and decisive response to the war in Ukraine; and we are able to make our own laws, one of which is precision breeding, which, again, we would like the Scottish Government to support.

Philippa Whitford: I thank the Secretary of State for his warm welcome, but I must point out that June Raine, the head of the Medicines and Healthcare products Regulatory Agency, has said innumerable times that the accelerated roll-out was under European Medicines Agency legislation. With the Labour party having now lashed itself to the mast of the floundering Brexit ship, does the Secretary of State at least recognise that the only route back to the EU for Scotland is as an independent country?

Alister Jack: The deficit in Scotland is considerably higher than 3%, which is the Maastricht criteria, so that is not the route back. The currency is a problem as well—as we know, the Bank of England is the bank of last resort, and there would have to be a new currency in Scotland following membership of the EU. There is no desire in Scotland to have membership of the EU. I believe that when Scots stop and look at the detail, whether it is on their pensions, trade or currency, they know that their home is the United Kingdom.

Community Assets

Douglas Ross: What steps he has taken to help Scottish communities protect community assets.

John Lamont: I thank my hon. Friend for his question. Scottish communities have benefited from the UK Government’s £150-million community ownership fund, which is a key pillar in our levelling-up agenda. To date, more than £2 million has been invested in 10 projects across Scotland through the fund, including more than  £200,000 to restore the not-for-profit community-run Old Forge pub on the Knoydart peninsula, and £250,000 in Perth and Kinross’s Rannoch hub to provide the historical building with new business and leisure facilities for the local community.

Douglas Ross: As it is 11 January, I wish everyone in Burghead a happy Clavie. In a historical tradition dating back to the 1750s, tonight, as his predecessors did, Clavie king Dan Ralph and his crew will carry a barrel of burning tar and oil through the streets up to Doorie hill to welcome in the new year. It is an incredible sight and I wish everyone well tonight. The Minister mentioned levelling up. He will know that Moray Council has submitted an ambitious bid that will see jobs and investment in Elgin and across Moray. Can he give us an update on that bid?

John Lamont: I am grateful to my hon. Friend for highlighting the activities taking place in Burghead tonight, and I wish Dan Ralph and his team well in the Clavie this evening. I welcome Moray Council’s engagement with the levelling-up programme. As he will know, the levelling-up fund invests in infrastructure that improves everyday lives across the United Kingdom. To date, eight Scottish projects have been successfully funded to a value of more than £171 million. The United Kingdom Government will shortly make an announcement on the successful bids from round 2 of the levelling-up fund, and I look forward to seeing more successful Scottish bids as part of that announcement.

David Linden: Can I ask the deputy assistant junior viceroy to be honest at the Dispatch Box that Scotland is being short-changed as a result of being dragged out of the European Union? We used to benefit from much more regional development money, rather than the poxy pork barrel politics of levelling-up money.

John Lamont: I am disappointed that the hon. Member does not welcome the Government’s additional investment into communities across Scotland. We are making decisions based on real devolution and supporting local councils across Scotland by investing in local communities, while the Scottish Government increasingly take more powers away from local councils.

International Trade Links

Sally-Ann Hart: What recent discussions he has had with Cabinet colleagues on strengthening Scotland’s international trade links.

Marco Longhi: What recent discussions he has had with Cabinet colleagues on strengthening Scotland’s international trade links.

John Lamont: Scotland is, of course, already benefiting from the United Kingdom’s independent trade policy. To date, we have signed 71 trade deals with non-EU countries and the European Union, which were worth £808 billion in 2021. We have further high-value deals in sight with the trans-Pacific region, India and the Gulf  states. My priority is to ensure that Scotland’s best interests continue to be represented in our ambitious programme of free trade agreement negotiations.

Sally-Ann Hart: The UK Government have an extensive overseas network via its embassies, the British Council and so on. What steps is my hon. Friend taking to ensure that the UK Government work collaboratively with Scottish businesses, especially small and medium-sized enterprises, and the Scottish Government to maximise opportunities and utilise resources to best promote the Scottish brand and businesses overseas?

John Lamont: Our response to the recent Scottish Affairs Committee inquiry into promoting Scotland internationally highlights the wide range of activities that the Scotland Office, the Foreign, Commonwealth and Development Office and the Department for International Trade are undertaking around the world to promote Scottish interests across diverse areas, including trade and investment. UK Export Finance has provided £2.1 billion to Scottish companies since 2016-17, supporting a range of businesses, including food processors, hydro research, manufacturing and renewable energy. Our approach to attracting foreign investment in Scotland is driven by the Office for Investment, which launched in 2020. The successes of the programme are clear, with 4,408 new jobs created by overseas investment.

Marco Longhi: Does the Minister agree that the United Kingdom securing the double taxation agreement with Brazil, with its 212 million population, is a very significant event for many Scottish exporting businesses, and that the UK’s work to agree geographical indication for Scottish whisky in Brazil will help secure even more jobs in Scotland?

John Lamont: Yes, I do agree, and I commend my hon. Friend for his efforts as the Government’s trade envoy to Brazil. As he will know, Scotland exports the most goods from the United Kingdom to Brazil, so it stands to benefit greatly from the agreement on double taxation, when implemented. Given the importance of the Brazil export market, I also share his ambition of securing GI protection for Scottish whisky in Brazil as soon as possible, with the obvious benefits this will bring to both producers and consumers of our national drink.

Jamie Stone: Mr Speaker, I assume you will be surprised and delighted to learn that last summer a Bollywood biopic was filmed in Caithness in my constituency. That was a lot of dosh being spent in the north of Scotland. Screen tourism brings in almost £65 million for Scottish businesses, and more than half the people in the UK think that Scotland is one of the finest film and TV locations. Can I ask the Minister what he will do to promote Scotland as one of the best film locations in the world?

John Lamont: I very much agree with the hon. Member’s points about the Scottish film industry. I know he had a distinguished career on the stage during his time in the pantomime season. There is a real opportunity here for Scotland. We can see the benefits for Scottish tourism of TV shows such as “Outlander” and the BBC’s recent “The Traitors”. I am meeting those from VisitScotland next week, and I look forward to discussing these opportunities further with them.

Pete Wishart: I do not know where all this tosh that we have heard comes from this morning, but the reality of trade arrangements in Scotland and the UK is that, because of Brexit, £15 billion less was spent in the last quarter of 2022 than would have been. What does the Minister have to say to businesses in Scotland suffering under this calamitous Brexit that they did not vote for, and when is he going to do something—or anything—that will help Scotland to escape this Brexit disaster?

John Lamont: I know the hon. Member and the SNP have historically been anti-trade, but this Government are unquestionably committed to expanding trade opportunities for Scotland. Trade continues to grow, trade continues to be an opportunity for the Scottish economy and trade creates jobs for Scotland.

Inflation and Cost of Living Increases

Chris Stephens: What recent assessment he has made of the impact of increases in (a) inflation and (b) the cost of living on Scotland.

Anum Qaisar: What recent assessment he has made of the impact of increases in (a) inflation and (b) the cost of living on Scotland.

John Lamont: Like many countries around the world, the UK faces the dual challenge of a recession and high inflation. That is why the Prime Minister has made tackling inflation a key priority. As outlined in the Chancellor’s autumn statement, this Government are committed to supporting the most vulnerable households across the United Kingdom with £12 billion of direct support in 2023-24. Alongside this, the energy price guarantee is saving a typical household in Scotland £900 this winter.

Chris Stephens: I thank the Minister for his response. He will know that, in contrast to the UK energy resources that were privatised under previous Conservative Administrations, France’s publicly owned company can cap energy prices at 4% and Germany has cut VAT on energy to 7%. May I ask him what representations he has made to Government colleagues about following European examples and preventing costs going up at source, saving money for people, businesses and taxpayers?

John Lamont: This Government are committed to supporting the most vulnerable in Scotland through this inflationary crisis with the extra support that is going to the Scottish Government—the record-breaking block grant, together with £1.5 billion of additional funding through the Barnett consequentials. That is on top of the energy support packages that have been put in place by this Government. This compassionate Conservative Government will continue to work to support the most vulnerable in Scotland and across the United Kingdom.

Anum Qaisar: Data from the UK Government shows that standing charges for Scottish households are above the UK average, yet Scotland is an energy-rich country in her own right, producing over 60% of the UK’s gas  and a third of its green electricity. This broken Westminster system results in people in my constituency of Airdrie and Shotts and those across Scotland struggling with the cost of living, so can the Department explain why people in energy-rich Scotland are paying more, despite being energy producers?

John Lamont: As the hon. Lady will know, Ofgem is currently reviewing the charging structure, and the UK Government continue to engage with Ofgem as part of that process. Ofgem is independent of the UK Government, and we look forward to the recommendations it brings forward.

Lindsay Hoyle: I call the shadow Secretary of State.

Ian Murray: Last week, analysis of average wages in Scotland showed that they are almost £800 lower in real terms than when this Government came to power 13 years ago. In my constituency, they are £6,000 lower. That is the result of 13 years of Tory and SNP incompetence and not growing the economy. Does the Minister agree that after 13 miserable years of Tory wage stagnation, and with inflation now soaring into double digits, the cost of living crisis for families in Scotland is made in Downing Street?

John Lamont: No, I do not agree with the hon. Gentleman. The Government are committed to ensuring that wages go further, and that people keep more of what they earn. From April 2023 we are increasing the national living wage by 9.7%—the biggest ever cash rise—meaning an extra £1,600 a year for a full-time worker over the age of 23. Since 2010 this Government have also increased tax-free allowances for income tax and national insurance by more than inflation, roughly doubling them in cash terms and taking millions more people out of paying tax altogether.

Ian Murray: I am sure when workers in Scotland cannot afford to pay their bills this winter they will be delighted to hear that! Workers in Scotland see their wages lower today in real terms than they were in 2010. It is no wonder that in Scotland teachers are on strike, and that nurses from the Royal College of Nursing and ambulance workers in the GMB have rejected the Scottish Government’s pay offers. It is the same across the UK, yet we now learn that instead of negotiating in good faith, the UK Government want to strip those workers of their rights. Does the Minister think it is right to clap nurses, teachers and many more public sector workers one year, only to propose sacking them the next for asking for a fair pay rise?

John Lamont: As the hon. Gentleman well knows, public sector workers are striking in Scotland because of the incompetency of the SNP Government in Edinburgh. This Government are taking action to ensure that public services are protected through anti-strike legislation, which is ensuring that people who use the NHS and other essential services are protected from those types of strike action.

Energy Bill Support

Margaret Ferrier: What discussions he has had with Cabinet colleagues on energy bill support for Scottish households.

John Lamont: The Government’s energy price guarantee continues to support households across Great Britain, including in Scotland. The Chancellor’s autumn statement set out how the scheme will be adjusted by reducing typical household energy bills to an annual equivalent of around £3,000 from April 2023 until April 2024, saving an average of £500 per household.

Margaret Ferrier: A constituent contacted me before Christmas because she was struggling to keep up with her home energy costs. When my office contacted her provider, we found there was little support for her as a victim of Home Energy and Lifestyle Management Ltd, with the huge costs related mostly to the green deal. What discussions has the Secretary of State had with his Cabinet colleagues about tailored energy support for Scottish victims of the green deal scam?

John Lamont: As the hon. Lady knows, the green deal was designed to ensure that people were able to make their households more energy efficient, but we have always been clear that the repayments should not have been greater than the savings delivered. If her constituent has been mis-sold something, it is important that a complaint is made to the loan provider, and ultimately to the Financial Ombudsman Service. If that route has been pursued and the hon. Lady still needs some assistance, will she please contact me as I am happy to meet her to discuss the matter further?

Lindsay Hoyle: I call the shadow Minister, Liz Twist.

Liz Twist: One reason families in Scotland are paying some of the highest electricity bills in Europe is that there have been 13 years of failed Tory and SNP energy polices. Scotland is a key contributor in delivering a secure, affordable low-carbon energy system for the whole UK. Under Labour’s proposals we would lower bills for Scottish households and be energy independent, with a plan for clean power by 2030. The former Conservative energy Minister, Claire Perry O’Neill, said:
“Labour are serious about Britain’s energy crisis—unlike my former party”.
Does the Minister agree with his former colleague?

John Lamont: I do not agree with the hon. Lady’s analysis. The Government remain committed to ensuring that the UK has a green, secured energy supply. I do agree with her assessment of the SNP’s failings—we saw that yesterday in its botched energy statement to the Scottish Parliament.

Scotland's Future

Ronnie Cowan: Whether he has made an assessment of the potential implications for his policies of the decision of the House on 14 December 2022 on the motion on Scotland’s Future.

John Lamont: I trust the hon. Gentleman recalls that the House overwhelmingly rejected the motion to which he refers. The Government are focused on delivering for the people of Scotland. That means helping to tackle the cost of living, protecting our long-term energy security and growing our economy.

Ronnie Cowan: I remember how in this place the Secretary of State for Scotland, while explaining the UK Government’s lack of appetite for a referendum on Scotland’s place in the United Kingdom, repeated many times that the route to a referendum in 2014 involved “consensus between both Governments.” Given that democracy is fuelled by consensus, is the Secretary of State for Scotland working towards establishing that consensus or is he content to deny the people of Scotland their democratic voice?

John Lamont: The Secretary of State for Scotland and the Government will continue to work with the Scottish Government to deliver on the priorities of the people of Scotland. They are: dealing with the cost of living; dealing with the NHS; and dealing with our education system, as well as a long list of other issues that the Scottish Government are completely failing to deliver on—certainly not another independence referendum.

Lindsay Hoyle: Order. Before we come to Prime Minister’s questions, I point out that a British Sign Language interpretation of proceedings is available to watch on parliamentlive.tv.

Prime Minister

The Prime Minister was asked—

Engagements

Cat Smith: If he will list his official engagements for Wednesday  11 January.

Rishi Sunak: This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today.

Cat Smith: There are no NHS dentists taking on patients in Lancaster and Fleetwood, and those constituents of mine who are lucky enough to have one are waiting months for an appointment. How long did the Prime Minister have to wait for his last NHS dentist appointment?

Rishi Sunak: As a result of the new reformed NHS dentistry contract, there are now more NHS dentists across the UK, with more funding, making sure that people can get the treatment they need. Let me answer the hon. Lady directly. I am registered with an NHS GP. I have used independent healthcare in the past—[Interruption.] I will answer her question. I am registered with an NHS GP. I have used independent healthcare in the past, and I am grateful to the Friarage Hospital for the fantastic care that it has given my family over the years. The truth is, I am proud to come from an NHS family, and that is why I am passionately committed to protecting the NHS with more funding, more doctors and nurses and a clear plan to cut the waiting lists.

David Johnston: A person is 24 times more likely to become a doctor if a parent is a doctor and 17 times more likely to become a lawyer  if a parent is a lawyer, and a lower proportion of dis-advantaged young people are being admitted to   degree-level apprenticeships by employers than to degrees by universities. I warmly welcome what my right hon. Friend set out last week about education and family, but does he agree that we also need our universities, employers and professions to play their part to improve social mobility?

Rishi Sunak: Everyone should have the opportunity to succeed, and my hon. Friend is absolutely right that we all have a part to play. That is why I am pleased that the Social Mobility Commission is working to provide new information to young people about the opportunities available to them as well as a toolkit for employers so that they can also play their part in improving social mobility.

Lindsay Hoyle: We come to the Leader of the Opposition.

Keir Starmer: In the 13 years of the last Labour Government, there were no national NHS strikes. If the Prime Minister had negotiated with the nurses before Christmas, they would not be on strike. If he had negotiated with the ambulance workers, they would not be on strike, either. Why is he choosing to prolong the misery rather than end these strikes?

Rishi Sunak: We have always been clear that we want to have constructive dialogue with the unions. That is also why, when it comes to the issue of pay, we accepted in full the independent recommendations of the pay review bodies. The right hon. and learned Gentleman simply does not have a policy when it comes to this question. He talks about wanting to end the strikes. The question for him is simple then: why does he not support our minimum safety legislation? We all know why. It is because he is on the side of his union paymasters, not patients.

Keir Starmer: When I clapped nurses, I meant it. The Prime Minister’s response to the greatest crisis in the history of the NHS is to threaten to sack our nurses. His Transport Secretary says it is not the solution. His Education Secretary hopes it will not apply in schools. His own assessments say it could increase the number of strikes. The simple truth is you cannot legislate your way out of 13 years of failure. Between 2010 and 2019, before anyone had heard of covid—[Interruption.]—the number of people stuck on the NHS waiting list doubled. Why do patients always wait longer under the Tories? [Interruption.]

Lindsay Hoyle: Order. This is the new year. I want to start off with a refreshed Chamber, and certainly not with interruption.

Rishi Sunak: The right hon. and learned Gentleman talks about the minimum safety legislation. Let us just talk about it a little bit further, because this is a simple proposition. No one denies the unions’ freedom to strike, but it is important to balance that with people’s right to access to life-saving healthcare at the same time. This should not be controversial. The International Labour Organisation supports minimum service levels. They are present in France, in Italy, in Spain. Normally he is in favour of more European alignment—why not now? [Hon. Members: “More!”]

Keir Starmer: They have gone from clapping the nurses to sacking the nurses, it is that simple. And to add insult to injury, they are the cause of the crisis. The Prime Minister’s Government commissioned a report on waiting times. He knows this: his own report says that this is not a covid problem; it is 10 years of managed decline. As a result, 7.2 million people are now waiting for treatment. He says he wants to be held to account over that, so let us be very clear: is his promise merely to get those numbers back to where they were before covid—that is 4.6 million—or back to where Labour had them in 2010, almost half that? Which is it?

Rishi Sunak: Again, let us just start with the facts. The right hon. and learned Gentleman seems to completely ignore the fact that not just in England, but in Scotland, in Wales and in many other European countries, covid has had an extraordinary impact on health services. We have a very clear plan to bring the waiting lists down and it is one that the NHS supports. I tell you what the NHS does not need: Labour’s only idea, which is for another completely disruptive, top-down, unfunded reorganisation buying out every single GP contract. Those are not my words. The CEO of the Nuffield Trust said it “will cost a fortune” and it is “out of date”—just like the Labour party.

Keir Starmer: So, the Prime Minister cannot tell us how much he will reduce waiting lists by or when. So much for the accountability he wants. As ever with this Prime Minister, you scratch the surface and you find there is nothing there. Last month, 1.4 million people waited more than four weeks for a GP appointment. When Labour left Government, you were guaranteed an appointment in two days. When does the Prime Minister expect to get back to that?

Rishi Sunak: We have already eliminated two-year wait lists: that was done last year. We are on track this spring to eliminate waits of 18 months, with a clear plan to go further and eliminate waits of 52 weeks by next spring. We are doing that with record funding, more community diagnostic centres, more surgical hubs and more patient choice. That is why I have made tackling wait lists one of my five priorities. What are the right hon. and learned Gentleman’s? They seem to change every single week. At first he was against NHS outsourcing; now he is apparently in favour of it. It is inconsistent, unprincipled and in hock to his union—

Lindsay Hoyle: Order. Can I just remind the Prime Minister that this is Prime Minister’s questions, not Opposition questions?

Keir Starmer: I heard the Prime Minister saying that he is now registered with an NHS doctor, so he will soon enjoy the experience of waiting on hold every morning at 8 am to get a GP appointment. I can tell him that those who are waiting now do not want another round of empty promises or boasting about what he has done; they just want to know when they will be able to see a doctor.
This is not just about routine care. There can be nothing more terrifying than being told you might have cancer: that is why the last Labour Government brought in a guarantee that people would be seen by a specialist within two weeks. Today, 50,000 people are waiting  longer than that. Everyone in this House will appreciate the anxiety that they are feeling. When will cancer patients once again get the certainty of quick care that they got under Labour?

Rishi Sunak: Why is there a challenge with cancer times right now? Again, the right hon. and learned Gentleman just has absolutely no understanding of the situation. What happened to cancer referrals during covid? They went down by almost two thirds. That was because of a pandemic. By the way, if we had listened to him, we would still be in lockdown and there would be even more waiting lists. Actually, right now there are record levels of cancer treatment as we catch up with those missed things.
The right hon. and learned Gentleman talks about what is terrifying. [Hon. Members: “It’s you!”] What is terrifying is that right now people do not know whether, when they call 999, they will get the treatment that they need. Australia, Canada and the US banned strikes by blue light services. We are not doing that. All we are saying is that in these emergency services, patients should be able to rely on a basic level of life-saving care. Why is he against that?

Keir Starmer: There is not a minimum level of service any day, because the Government have broken the NHS. The Prime Minister is not promising that people will get to see a doctor in a few days, like they did under Labour. He is not promising that cancer patients will get urgent treatment, as they did under Labour. He is not even promising an NHS that puts patients first, like it did under Labour. No, he is promising that one day, although he cannot say when, the Government’s record high waiting lists will stop growing—and that’s it. After 13 years in government, what does it say that the best they can offer is that at some point they might stop making things worse?

Rishi Sunak: When it comes to the NHS, it is crystal clear: the Conservatives are on the side of patients, Labour is on the side of its union paymasters. I have laid out my priorities for the country: waiting lists down, inflation down, debt down, growth up and the boats stopped. All the right hon. and learned Gentleman does is flip from one thing to another. That is the difference between him and me. He is focused on petty politics; I am delivering for Britain.

Cherilyn Mackrory: On behalf of my constituents in Truro and Falmouth, I would like to thank all the health and social care professionals in Cornwall for their hard work in a particularly difficult winter. Everybody comes to Cornwall for their summer holidays, which is brilliant, but it means that there is no respite in summer or winter for our health and social care professionals. In addition, when we try to recruit people into health and social care, which is a vocation, the sector is competing with hospitality. Is my right hon. Friend the Prime Minister aware of the extra challenges that places such as Cornwall face in recruitment and retention?

Rishi Sunak: My hon. Friend is right to shine a spotlight on that issue. Like her, I am incredibly proud of all our social care workers and their commitment to their profession. That is why, this spring, many of them  will benefit from an increase of nearly 10% in the national living wage, which will put an extra £1,600 on to their payslips. However, we also want to make sure that they feel valued through professional development training and career progression, and our half a billion pounds of investment in the social care workforce will do exactly that for the workers in my hon. Friend’s constituency and for others.

Lindsay Hoyle: I call the Scottish National party spokesperson.

Stephen Flynn: Given the longest and deepest recession in the entire G7, Brexit, 13 years of Tory rule, the energy price crisis, inflation and high interest rates, if the people of Scotland do the maths—as the Prime Minister so hopes—will they not come to the conclusion that this Union simply does not add up?

Rishi Sunak: I am pleased that the hon. Gentleman brought up the subject of energy. He was right to do so. When it comes to the economy, energy is incredibly important to Scotland, and Scotland will play a fantastic part in helping us make the transition to net zero. We now know, however, that the Scottish Government do not want to support the Scottish energy industry and the 200,000 jobs that it produces. I am keen to work with the Scottish Government to support the North sea, because it is something of which we are all very proud in the United Kingdom.

Stephen Flynn: If the Prime Minister wants to talk about the fact that Scotland is energy rich but fuel poor on Westminster’s watch, I am more than happy to do that. For today, however, let us reflect on numbers, and in particular the numbers on which Sam Coates of Sky News shone a light—notably those relating to the Prime Minister’s favourite potential successor, which showed that over four months, for four speeches, he had raked in more than £1 million. Does the Prime Minister not find it utterly perverse that senior members of the Conservative party are feathering their nests in this way, while at the same time seeking to deny working people the opportunity to strike for fair pay?

Rishi Sunak: I do not think we need to talk about our predecessors, but I remember—[Interruption.] If I am not mistaken, it was one of the hon. Gentleman’s predecessors who worked for Russia Today.
The hon. Gentleman talks about priorities. Yesterday the SNP spent time talking yet more about independence at a time when we should be talking about delivering for people across the United Kingdom, focusing on their jobs and improving the NHS throughout the UK, in Scotland and, indeed, everywhere else. That is the kind of thing I want to talk to the Scottish Government about, and I hope the hon. Gentleman will work with me to do that.

Holly Mumby-Croft: Conservative Governments have a proud record of supporting the UK steel industry, and I thank my right hon. Friend for the work that he has already done for steel. He will know that steel is a vital strategic industry that is essential for everything we do, from defence to growth. Will he do everything he can to ensure that we  are always able to make steel in this country, and does he agree that steel is always safest under a Conservative Government?

Rishi Sunak: My hon. Friend is a fantastic champion for the steel industry, and this Government remain committed to a thriving UK steel industry. That is why our support for steel includes nearly £800 million in relief for electricity costs and steel companies are eligible to bid for up to £1.5 billion in capital grant to speed their transition to net zero steel production.

Liz Saville-Roberts: I am sure the whole House will want to join me in wishing all the best to Gareth Bale, the former captain of the Wales men’s soccer team, who has been a national inspiration and who took Wales to the football World Cup.
This Tory Government attack dedicated health and ambulance staff, but disruption from strikes is as nothing compared with the chronic disruption caused every day by their 13 years of butchering health budgets. Meanwhile, Labour’s Health Secretary in Wales follows the Tory playbook, blaming patients themselves for standards of health. The reality is this: health services in Wales suffer from a combination of mismanagement by Labour and a Westminster funding system that perpetuates poverty. The Prime Minister used to talk about levelling up—[Interruption.]

Lindsay Hoyle: Order. The question is far too long. The Prime Minister must have got the drift.

Liz Saville-Roberts: Will the Prime Minister therefore commit himself to funding Wales’s public—

Lindsay Hoyle: Order. I call the Prime Minister.

Rishi Sunak: Let me join the hon. Lady, because as a Southampton fan, Gareth Bale is also a hero of mine and I wish him well. When it comes to funding Wales, it is because of the funding from Barnett that the Welsh Government receive significantly more funding than the NHS in England, but also £1.2 billion of extra funding as a result of the autumn statement. I say what I said to the leader of the Opposition: this is not about political point scoring. The NHS is under pressure in Wales as it is in Scotland and England, in large part because of the impact of the global pandemic. She would do well to recognise that.

David Duguid: Unlike parties opposite, including the Scottish National party—even the hon. Member for Aberdeen South (Stephen Flynn)—I know my right hon. Friend recognises the critical role that oil and gas companies and their employees have in not only providing energy security but delivering the energy transition to net zero. Can he confirm this Government’s ongoing commitment to expanding our carbon capture utilisation and storage capacity, including the Acorn project in St Fergus in my constituency? Can he provide an update on the track 2 sequencing?

Rishi Sunak: My hon. Friend is a fantastic champion and campaigner for this project. We will invest up to £1 billion to establish carbon capture and storage in four industrial clusters by 2030. We very  much recognise the benefits of the Scottish cluster and the role it could play in decarbonisation, and we are progressing track 2 and will set out further details in due course.

Alex Davies-Jones: recently reported that schools across the UK are in crisis as the effects of online influencer Andrew Tate’s vile misogyny infiltrates our classrooms and society. Teachers are now having to develop their own resources to re-educate boys who are being brainwashed online by his deeply toxic messaging. The Prime Minister has been too slow to recognise the damage that this is causing. What has he done, and what are his Government doing to tackle this misogyny and incel culture and the radicalisation of young men in this country? Will he commit to giving the teachers the resources that they need to address this problem head on?

Rishi Sunak: With regard to funding, we announced in the autumn statement £2 billion of extra funding for our schools. I am also proud that this Government have introduced the world-leading, world-first Online Safety Bill, which specifically improves protections for children and puts very strict obligations and penalties on tech companies for enforcing them.

Kevin Foster: The building a brighter future project for Torbay Hospital will be the biggest single investment in south Devon’s healthcare services since the NHS was founded in 1948. Can my right hon. Friend assure me that the Government’s commitment to it remains unchanged?

Rishi Sunak: My hon. Friend is a fantastic champion for his local hospital and constituents. I am pleased to say that the new hospital scheme for Torbay is part of our plan to deliver dozens more hospitals by 2030. We remain committed to the delivery of that new hospital, and I am pleased his trust is talking to the new hospital programme team about how to progress those plans.

Alex Cunningham: Taxpayers are set to lose tens of millions of pounds after the transfer of valuable public assets to two Teesside businessmen, all without a full and transparent recruitment process. A relative of one of those people is now benefiting from millions of pounds-worth of scrap from the same Tees work site. Will the Prime Minister launch an inquiry into these crony contracts? While he is at it, will he tell his Environment Secretary to get serious about the environmental disaster in the Teesside estuary, which was linked to the site?

Rishi Sunak: As the hon. Gentleman will already be aware, the Department for Environment, Food and Rural Affairs already carried out a comprehensive, evidence-led investigation, considered everything robustly and concluded that natural causes were most likely responsible for some of the things that we saw. But we recognise that people want a thorough investigation of this issue, and DEFRA has confirmed that an independent panel will be set up to report quickly.

Philip Davies: Labour-controlled Bradford Council continually neglects the needs of Bingley and other parts of my constituency, as   they pour all their money into their inner-city heartlands. Therefore, my constituents look to the Government to put right their failings. That is why the levelling-up fund is so important. Will the Prime Minister insist that the levelling-up fund bid submitted for Bingley, which will unlock millions of pounds of private sector investment, will be successful when the announcement is made in the near future?

Rishi Sunak: Unlike the Labour council, my hon. Friend is a fantastic champion for his constituents in Bingley. As I have told him previously, I cannot comment on individual bids but I wish him every success and will be following with close interest how it proceeds.

Carolyn Harris: Does the Prime Minister believe that over 40,000 interactions, either by social media, email or letter, regarding the poor customer service and working conditions at the delivery company Evri warrant an investigation by the relevant Government Department? His Ministers in the Department for Business, Energy and Industrial Strategy think not, but I am sure the Prime Minister would want the general public to believe that he at least is interested enough in this problem to take action.

Rishi Sunak: I am aware that other Government Ministers have looked into this issue and are currently considering the matter at hand. I will be happy to write to the hon. Lady when we know more about the situation.

Fiona Bruce: Does the Prime Minister agree that the right way to secure the best future for the British people is to deliver on the people’s priorities and secure a strong economy? Will he confirm that he will not make any unfunded spending commitments that would rack up billions of debt, as the Labour party has done in the last week?

Rishi Sunak: My hon. Friend is absolutely right. If we want to safeguard the future of our public services and make sure that our young people inherit a strong economy, we must be disciplined on spending and borrowing. She is absolutely right about no unfunded spending commitments, unlike the Labour party, as she says, which at the last count has made £90 billion of unfunded spending commitments. It is the same old Labour: it always runs out of other people’s money.

Simon Lightwood: Less than half of Wakefield’s children managed to see an NHS dentist last year. My constituent Mr Faqirzai’s six-year-old daughter has never seen an NHS dentist. She has 10 teeth that are black with decay and is often crying in pain. Her father feels helpless. He has called every dentist in Wakefield for a place but has not managed to secure one. More than 25% of five-year-olds in Wakefield already have visible tooth decay, so when will the Prime Minister stop dithering and take action to address our national dental emergency?

Rishi Sunak: I am very sorry to hear about the case raised by the hon. Gentleman, and I am happy to look into that specific one more closely. As I said in answer to an earlier question, we have recently reformed   the NHS dentistry contract, and the hundreds of millions of pounds more funding and more dentists should make a difference around the country, but I will write to him on that specific case.

Douglas Ross: Scotland’s oil and gas industry supports 90,000 Scottish jobs, but yesterday Nicola Sturgeon’s SNP Government published plans calling for the shutdown of the industry as fast as possible and an end to new exploration. These plans are naive and reckless and were previously described by the SNP leader in this House as “crazy”. Will the Minister reaffirm his support for Scotland’s oil and gas workers and the future of our industry?

Rishi Sunak: My hon. Friend is absolutely right. We know that we will have to rely on hydrocarbons for decades to come as we transition to net zero, and consuming oil and gas from the North sea means less than half the carbon footprint of importing that same oil and gas, so it obviously makes sense to do it here and in the process support tens of thousands of jobs in Scotland. I can reassure him that the Scottish oil and gas industry has this Government’s wholehearted support.

Marsha de Cordova: The Tory crisis in the NHS includes ophthalmology, the largest and busiest out-patient service. There are more than 650,000 people waiting to see an eye care specialist. Will the Prime Minister back my Bill calling for a national eye health strategy that would ensure that nobody waiting to see a specialist will go without, potentially leading to a complete loss of sight?

Rishi Sunak: I thank the hon. Lady for her campaigning in this area. We are taking action to improve things. Over the past five years the National Institute for Health and Care Research has invested more than £100 million to support research into eye conditions, but I know there is more we can do and my hon. Friend the Minister is, I believe, sitting down to talk to the hon. Lady in due course. I look forward to hearing about those conversations.

Iain Duncan Smith: Today, I and others met Sebastien Lai, the son of Jimmy Lai—the ex-owner of Apple Daily who languishes in prison. I remind my right hon. Friend that Jimmy Lai is a British citizen and a British passport holder, and he now faces a trial at the end of the year in which, under the new national security laws, he can be incarcerated for life. And for what? For publishing truth to power.
Will my right hon. Friend please direct his Government, particularly the Foreign Office, to warn the Chinese Government, as the Americans have already done, with the threat that if they persist, the use of common law in Hong Kong will be taken away?

Rishi Sunak: My right hon. Friend speaks with authority, and I thank him for his continued engagement on this critical issue. He knows the actions we have already taken with regard to Hong Kong, not least providing refuge for hundreds of thousands of people and being robust in standing up to what we   believe to be Chinese aggression and the undermining of the settlement that we fought so hard to achieve. He has my absolute assurance that I will remain robustly engaged, and I look forward to sitting down with him to discuss this particular issue in more detail as soon as possible.

Wera Hobhouse: Half of British women and a fifth of men have been sexually harassed at work or at their place of study. The Government’s own figures show that 41% of them say their perpetrator faced no consequences. Thanks to cross-party and Government support, my private Member’s Bill, which has now passed through Committee, will bring about a culture change to protect workers from harassment and sexual harassment, both from fellow employees and from third-party individuals. Will the Prime Minister join me in celebrating the cross-party work on this important change in the law and, by personally supporting its aims and objectives, will he ensure its continued safe passage through Parliament?

Rishi Sunak: I thank the hon. Lady for her important work on this issue. Sexual harassment has absolutely no place in the workplace. Everyone should feel safe at work. Of course, we need to make sure that legislation does not have unintended consequences, but I know she is meeting my right hon. Friend the Minister for Women and Equalities to discuss the Bill further. I look forward to hearing about the progress in that meeting.

Matthew Hancock: Does the Prime Minister agree that the disgusting antisemitic, anti-vax conspiracy theories promulgated online this morning are not only deeply offensive but anti-scientific and have no place in this House or in our wider society?

Rishi Sunak: I join my right hon. Friend in completely condemning, in the strongest possible terms, the types of comments we saw this morning. Obviously, it is utterly unacceptable to make such linkages and to use such language, and I am determined that the scourge of antisemitism be eradicated. It has absolutely no place in our society. I know the previous few years have been challenging for the Jewish community, and I never want them to experience anything like that again.

Nadia Whittome: My 95-year-old constituent spent 41 hours in A&E. When will the Prime Minister admit that the NHS is collapsing because of 13 years of underfunding and do something about it, instead of blaming the nurses who are striking to save it?

Rishi Sunak: First, I am very sorry to hear about the experience of the hon. Lady’s elderly constituent. My sympathies go out to her, but this is not about blaming anybody. This is about recognising that the NHS, whether in Scotland, in Wales—where it is run by the Labour party—or here in England, is facing pressure as we recover from the pandemic. The right thing to do is to have a clear plan in place to work with doctors and nurses to ease that pressure. That is what we are focused on doing, and that is what our plan will deliver.

Renewable Liquid Heating Fuel

Motion for leave to bring in a Bill (Standing Order No. 23)

George Eustice: I beg to move,
That leave be given to bring in a Bill to reduce the duty charged on renewable liquid heating fuel; to provide for the imposition of obligations on suppliers of heating fuel in relation to the supply of renewable fuel; and for connected purposes.
Although, obviously, no ten-minute rule Bill can compete with Prime Minister’s questions for the attendance of hon. Members, I have been heartened by the extraordinary expressions of support I have had for this proposed legislation from Members from all parts of the House. In addition to those who have agreed to sponsor the Bill, others have offered support in taking it forward, including my right hon. Friend the Member for Ludlow (Philip Dunne), the Chair of the Environmental Audit Committee; my hon. Friend the Member for North East Bedfordshire (Richard Fuller); and my hon. Friend the Member for Ynys Môn (Virginia Crosbie).
It is no surprise that the Bill should have such support, for 1.7 million homes in the UK are off the gas grid—about 1.1 million in Great Britain and a further 600,000 in Northern Ireland. They are mainly in rural communities and they mostly rely on kerosene boilers for their heating. As we chart a course towards net zero, finding a low-carbon solution for these homes is going to be incredibly important. In 2017, the Government introduced the green growth strategy, which concluded that there should be a concept of electrification first in respect of such homes. That mantra has been repeated in consultations since, and in 2017 the Government also indicated that they wanted to seek to remove boilers from off-grid homes in these rural communities after 2026.
More recently, the heating and building strategy in 2021 and two associated consultations on homes off the gas grid moved further, saying that there should be a heat pump first strategy. The Government propose that, from 2026, the installation of replacement boilers will be banned in those off-grid properties and instead households in those rural communities will be forced to have either air source heat pumps or ground source heat pumps. Don’t get me wrong: there is a role for both air source and ground source heat, and I am a supporter of those technologies. Indeed, Cornwall has impressive geothermal resources and companies such as Kensa, which is a national market leader in this technology.
However, there are some drawbacks to air source heat pumps in particular, and that technology is not right for everyone. The capital cost is very high; at about £12,000, it is at least three times the cost of a new boiler. In some coastal areas, the equipment can be prone to decay and rusting. It also requires a lot of additional insulation in homes, with which comes a lack of ventilation. In some old properties, an associated problem of increased insulation is an increased risk of mould and the health problems that come from that.
The Bill would establish a better path towards decarbonising our energy in these off-grid homes, because the technology now exists to adapt existing boilers to run not on kerosene but on hydrotreated vegetable oil, a renewable fuel derived from waste. The adaptation to the boilers is very modest, involving a small change to a  nozzle, an adjustment in the pressure and sometimes a clean of the tank. The cost of the adaptation is no more than a few hundred pounds. The Government’s work in this area on their standard assessment procedure for building energy efficiency—the so-called SAP document—shows that switching to HVO as opposed to kerosene would lead to an 88% reduction in greenhouse gas emissions, which would be an extraordinary achievement.
In my constituency, the small village of Kehelland has been taking part in a fascinating pilot, organised by local fuel distributor Mitchell & Webber. Residents, the local school and the chapel have all taken part in the switch to the use of HVO. I met them shortly before Christmas and found that the results were fascinating. Typically, fuel consumption is around 30% to 35% lower than for kerosene. Residents reported slightly higher temperatures in their radiators. The local chapel made a very good point, which is that it only needs heat intermittently—that is, when communities are using the hall. It does not want an air source heat pump running continuously to keep temperatures high; it wants to be able to switch that energy off and on, which makes this an ideal solution.
The Government have long recognised the value of renewable fuels in the transport sector. We have the renewable transport fuel obligation, which requires fuel manufacturers and importers to purchase a proportion of fuel from renewable sources. The Bill would extend the RTFO mechanism to cover the use of renewable fuels in domestic boilers and remove the current duties from these renewable fuels, which are entirely counterproductive.
The intended impact of my Bill is to reduce the cost of HVO so that it can achieve parity with kerosene. If we get parity of cost with kerosene—the cost of conversion is modest—we will see a very rapid adoption of HVO. The key thing is that, if the Government were to target carbon emissions, the incentive to use renewable fuels would become quite obvious. The challenge is that the Government are not so much targeting carbon with their current strategy, as targeting the adoption of a chosen technology. They have chosen a winner in air source heat pumps, and that is how they are measuring their success. The risk that they face with their current strategy is that people will put off the decision to make that huge capital expenditure in air source heat pumps. They will patch up their boilers to keep them going, replacing parts when they might otherwise have replaced the whole boiler. That means that the current strategy is unlikely to yield any results in carbon reductions until at least carbon budget 6 in the mid to late 2030s. The great advantage of my proposal is that there would be a rapid uptake of HVO within carbon budget 4—literally within the next four years. Within those four years, we would see a dramatic 88% reduction in carbon emissions.
In conclusion, if we are to meet our net zero ambitions and those crucial carbon budget staging posts in the meantime—4, 5 and 6—the key is to make it as easy as possible for people to make the change. The easier we make it and the more effort we put into making sure that they do not need to change their way of life, the faster the uptake will be; and the faster we get uptake, the quicker we will get to net zero.
I welcome the fact that the Minister for Energy and Climate, my right hon. Friend the Member for Beverley and Holderness (Graham Stuart), has listened to this  speech. The Government have forthcoming responses to two consultations in this area, and they have a wonderful Energy Bill that is ripe for amendment—I look forward to it returning to this House. I hope that my right hon. Friend the Minister will engage further with this proposal, but, for now, I commend the Bill to the House.
Question put and agreed to.
Ordered,
That George Eustice, Sir Gary Streeter, Kevin Foster, Anne Marie Morris, Mr David Jones, Jim Shannon, Ben Lake, Sir Mike Penning, Mr Robin Walker, Selaine Saxby, Ian Paisley and Derek Thomas present the Bill.
George Eustice accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 3 March, and to be printed (Bill 224).

Opposition Day - 11th Allotted DayOpposition Day

Fair Taxation of Schools and Education Standards Committee

12.44 pm

Bridget Phillipson: I beg to move,
That the following Standing Order shall have effect until 31 December 2023:
Fair Taxation of Schools and Education Standards Committee
(1) There shall be a select committee, to be called the Fair Taxation of Schools and Education Standards Committee, to consider reforming the tax status of private schools in order to raise funding for measures to increase educational standards across the state sector, including the recruitment of new teachers, additional teacher training, and careers advice and work experience for all pupils.
(2) It shall be an instruction to the committee that it shall make a first report to the House no later than 20 July 2023.
(3) The committee shall consist of eleven members of whom ten shall be nominated by the Committee of Selection in the same manner as those select committees appointed in accordance with Standing Order No. 121.
(4) The chair of the committee shall be a backbench member of a party represented in His Majesty’s Government and shall be elected by the House under arrangements approved by the Speaker.
(5) Unless the House otherwise orders, each member nominated to the committee shall continue to be a member of it until the expiration of this Order.
(6) The committee shall have power—
(a) to send for persons, papers and records, to sit notwithstanding any adjournment of the House, to adjourn from place to place, and to report from time to time; and
(b) to appoint specialist advisers to supply information which is not readily available or to elucidate matters of complexity within the committee’s order of reference.
(7) The committee shall have power to appoint a sub-committee, which shall have power to send for persons, papers and records, to sit notwithstanding any adjournment of the House, to adjourn from place to place, and to report to the committee from time to time.
(8) The committee shall have power to report from time to time the evidence taken before the sub-committee.
In this House we often talk of tough choices, especially since the Conservatives crashed the economy, but today I present the House with a very easy choice: to invest in the future of every child or to protect tax breaks for the wealthiest. We on the Opposition side know where we stand. Labour believes that excellence is for everyone—excellence for every child, in every school, in every corner of our country. I ask hon. Members to support that ambition by establishing a new Select Committee to consider how to end the inexcusable tax breaks that private schools enjoy and invest that money in driving up standards across all our state schools.
The evidence for ending private schools’ tax breaks is very clear:
“Removing the tax advantages of private schools would boost standards in the state sector and raise vital extra funds”.
I agree, but those are not my words; they are the words of the now Secretary of State for Levelling Up, Housing and Communities. It should be an easy choice, but we have tabled this motion because once again the Government are failing—failing to stand up to the vested interests in their own party, failing to consider the evidence even when their own Members have previously urged them to act and, yet again, failing our children.

Simon Hoare: There will be nobody who does not agree with the basic premise that we want to see excellence in all of our schools. Can the hon. Lady explain why she thinks she needs a Select Committee to achieve her aspiration? Surely she needs either an amendment to a Finance Bill or primary legislation? She does not need a Select Committee.

Bridget Phillipson: We will be considering all of our options for how to force this issue, but this is a choice for Conservative Members. There is a clear and straightforward way that we could look carefully at this issue, and the motion sets that out. The question for Conservative Members is whether they are prepared to defend inexcusable tax breaks for private schools, or whether they want to invest that money in ensuring that all our children in our state schools get a great start in life.

Jonathan Gullis: May I ask the shadow Secretary of State whether any Labour Members on the current Education Committee have put such ideas forward to its Chair for investigation by the existing Select Committee?

Bridget Phillipson: I cannot speak on behalf of other hon. Members, but I will happily address the point about the substance of the Select Committee in a moment.
Our children are at the heart of Labour’s ambition for Britain. Children alive today can expect to live into the next century, with the pace of change increasing and technological advancements growing. We must equip them for that world, and that must shape how we think about our schools today and tomorrow, about what it means to grow up in this country and about what the country they inherit will become. Children do not lack vision. Time and again, when meeting, talking to and listening to children, I am struck by their optimism and ambition, and not just for themselves and their families, but for our country and our world.
I am determined that, in government, Labour will match that ambition. The education we provide for our children today will shape all our futures, and by delivering an excellent education for every child, we will build a better future for all levels. A child at school now cannot pause and wait for change; they get only one childhood and they get only one chance. Our job is to make sure that their childhood is the best it possibly can be.
This House should not wait either. The Government have told us that they are not prepared to act. The hon. Member for Worcester (Mr Walker), the Chair of the Education Committee, has set out his priorities—I am glad to see that someone in his party is talking about childcare for once, and I welcome his Committee’s interest in this area. However, we urgently need action there too, driving up school standards and the opportunity to end private schools’ tax breaks. A new direction and new ambition are needed to drive forward that change.

Emma Hardy: When I was on the Education Committee in 2019—just for the information of the hon. Member for Stoke-on-Trent North (Jonathan Gullis), conversations about future work tend to happen confidentially within a Select Committee—we produced a report on special educational needs and disabilities, which one of our best pieces of work. In that report we highlighted the need to train teachers and people working in schools on SEND as a key priority. The money that my hon. Friend the shadow Secretary of State is talking about could be used to provide that training, the need for which was identified back in 2019, but which is yet to take place because schools do not have the funding they need and the Government are prioritising tax breaks for private schools instead.

Bridget Phillipson: My hon. Friend is absolutely right. I will set out in more detail exactly what difference that money could make to delivering a brilliant education for all our children.
On money, the case could hardly be stronger. After more than a decade of Conservative Governments, what do we have to show for it? We have childcare in crisis, a recovery programme in chaos, staff leaving our schools in their droves, school buildings collapsing, attainment gaps widening, apprenticeship numbers in freefall, colleges being pushed to the brink, and universities treated as a political battleground, not as a public good.
Once again, it will be the task of the next Labour Government to repair our schools system and equip it for the future. But we know that takes money. As the cost of living crisis spirals, the Government have imposed the greatest tax burden for 70 years, reaching again and again into the pockets of working people to fix their mess. Labour will put our children, their futures and the future of our country first by asking those with the broadest shoulders to contribute their fair share; by requiring private schools to pay business rates, as state schools already do, and to pay VAT, as our colleges already do.
At this time of economic uncertainty, asking the public to subsidise a tax break for private schools is inexcusable. We are not talking about small sums. Putting VAT on independent school fees would raise “about £1.7 billion”—those are the Chancellor’s words, not mine.

Alexander Stafford: The hon. Lady talks about these so-called tax breaks. Does she not appreciate that all private schools have a duty to give bursaries and scholarships? I myself went to a private school, and I could only afford to do so on a bursary. Does she not understand that her plans will destroy that, making private schools the privilege only of the super-rich and absolutely destroying the middle classes? The people of Rother Valley who send their children to Mount St Mary’s College and other private schools often do so through bursaries. Why does she want to deprive my constituents of that sort of education?

Bridget Phillipson: I will come in more detail to the record of private schools on the means-tested support that they make available, and on falling partnerships, but I have to tell the hon. Gentleman that it is not a great record. I gently suggest to him that the people of  Rother Valley and across our country—the vast majority of whom send their children to state schools—would prefer his focus to be on driving up standards in state schools, not on defending the tax breaks enjoyed by private schools.

Ruth Edwards: rose—

Alexander Stafford: rose—

Bridget Phillipson: I have heard enough from the hon. Gentleman, thanks.
On funding, we could do so much to drive up standards in schools for all our children. The new committee would look at the ways in which money raised from ending tax breaks for private schools could support high standards for all our schools everywhere, including through recruiting new teachers. We know that the most important factor for boosting children’s learning in school is the quality of teaching. Teachers, school leaders and support staff are doing an incredible job to support our children, but there are simply not enough of them. Under this Government, teacher vacancies have more than doubled, there are more than 2,000 temporarily filled posts a year, and teacher recruitment targets have been missed yet again. More teachers are leaving than entering our classrooms. For a decade they have been overworked, overstretched and undervalued. Our growing teacher recruitment and retention crisis was created by this Government.
Labour has said that we would use the money raised by ending private schools’ tax breaks to support our teachers. We would invest in recruiting thousands of new teaching staff, filling those vacancies and plugging skills gaps, and ensuring that teachers are not burnt out because they are covering their own job and someone else’s. Once they are in our schools, we will support every teacher with the knowledge and skills they need to thrive, and with an entitlement to ongoing training, so that instead of trying to squeeze learning for professional qualifications into evenings or weekends, or the odd session on an inset day, teachers are encouraged and supported to take on learning opportunities.
Labour would support teaching staff with the skills that they say they need to support children who have special educational needs and disabilities or who have learned English as a second language, and would help them to develop their professional expertise in the curriculum or knowledge sequencing. That training would ensure that teachers are confident in their expert knowledge and can help every child to thrive. Those steps would help the next Labour Government to ensure that every child is taught by a qualified teacher. Every child and every parent should have that guarantee.

Caroline Dinenage: Of course, we all agree with the hon. Lady about all children going to excellent schools and being taught by excellent teachers. Can she set out her plans for armed forces families, who are so well supported by private schools up and down the country? My constituency has so many forces families. More than 5,000 forces family children in this country, particularly those from single-parent families, go to boarding school to allow their parents to be deployed. The continuation of the education allowance covers  some of that, but so often it is backed up by the bursaries given by schools and by taxpayers’ money. Can she set out how her plans would protect children from armed forces families?

Bridget Phillipson: I join the hon. Lady in paying tribute to our amazing armed forces and the contribution that they make to keeping our country safe. It is right that they are properly supported and recognised. However, those numbers are starting to fall. Clearly, the Committee that we are recommending could consider all such areas. We do not anticipate that the proposals would cover specialist provision either, for example. There are ways in which they can be carefully drawn to ensure that exemptions apply where they should. I join her in paying tribute to the armed forces—she need not be concerned about what we are discussing today.
Our school staff are at the heart of our education system, but they have been let down. That is never clearer than when the Government refuse to work with them. No teacher wants to strike, no headteacher wants to close their school, and no teaching assistant or educational support worker wants to miss out on time with the children they help to succeed—they go into teaching to improve and transform lives—but this Government’s neglect means that they feel they have no choice. The Government are still failing to take seriously the urgent need to get around the table and prevent strike action.
For months, a merry-go-round of Education Secretaries and chaotic mismanagement has seen our children and our schools go neglected. We have had five Education Secretaries in one year; it is no wonder that no solutions have been found. After months of refusing to meet, to negotiate or even to acknowledge the problems around pay and conditions, an eleventh-hour meeting was little more than window dressing. The Government could still avert strike action, but they need a plan and they need to start working with teachers now.
Labour has set out our plan. Through recruiting new teachers and valuing those in the profession, we would work together to help every child to thrive.

Alex Cunningham: I am sure that my hon. Friend will join me in paying tribute to teaching assistants and school support staff, who play such a tremendous role in educating and assisting in the classroom. Many of our schools face the prospect of having to do away with teaching assistants simply because of budget pressures. Does she agree that our plan goes some way to addressing that?

Bridget Phillipson: My hon. Friend is absolutely right. We all see and recognise the value that our teaching assistants, learning support assistants and school support staff bring to our schools. Our teachers just could not do their jobs effectively without them. We all recognise their contribution, and I join him in paying tribute to them.

Jim Shannon: For everyone in this House, there is nothing more important than our support for children’s education and ensuring that standards in all schools are up to scratch and equal. In the thoughts that the hon. Lady is putting forward, can she address the issue of underachievers? I know that the  Minister of State at the Department for Education, the right hon. Member for Harlow (Robert Halfon), was at one time very keen on that issue. In my constituency, and across the whole of the United Kingdom, people—young, white Protestants, can I say?—underachieve because they do not get the educational opportunities that they need. Does the hon. Lady feel that what she is proposing can change that to the benefit of people who do not get the educational standards that they should?

Bridget Phillipson: Here in England we see growing and widening attainment gaps in many areas, but I point out to Ministers that we saw that starting to happen even before the pandemic hit. We all recognise and appreciate the impact that covid has had on our children’s education and wellbeing. I still think it is shameful that the Government failed to act on Sir Kevan Collins’s recommendations to bring forward a thorough recovery plan to support all our children. The Prime Minister claimed, when he was Chancellor, that he had “maxed out” on the support available to our children. Sadly, that will cast a very long shadow over children’s life chances here in England.
Our teachers do so much to improve the lives of children, but over the last few years they have truly gone above and beyond. From the covid pandemic to the cost of living crisis, our schools are supporting and holding communities together. They are doing an incredible job, but they cannot change all that happens beyond the school gates. Rising child poverty is holding children back, as is the growing mental health crisis. Too many children are struggling with their mental health, and they are struggling without support—unable to see a GP, stuck on child and adolescent mental health services’ waiting lists for years and left in limbo without help. No child should be left without the support they need to be happy and healthy, and no parent should be left feeling unsupported and alone when helping their child to face mental health problems.
We know that supporting young people with mental health is putting another burden on schools and our overstretched school staff, and the Government just are not doing enough. Mental health support teams are reaching a fraction of the children who could benefit. Senior leaders are being required to take on yet another responsibility for children’s mental health, because child and adolescent mental health services are unable to tackle the backlogs. We all know that wellbeing is essential to enabling children’s learning, but again the Government are letting young people down.
Using the money raised, Labour will give children access to professional mental health councillors in every school. We will ensure that children are not stuck waiting for referrals, unable to get support, and that teachers are not trying to carry the burden of young people’s mental health on top of wider workloads. We will ensure that every child knows that help is at hand. For young people for whom accessing support in school is not the right choice, we will deliver a new model of open-access youth mental health hubs. Providing an open door for all our young people, getting support to children early, preventing problems from escalating, improving young people’s mental health, not just responding when they are in crisis, and enabling them to learn and to thrive—that is Labour’s plan.

Florence Eshalomi: One of the issues that we see, sadly, is the stigma associated with mental health, especially in some communities. Does my hon. Friend feel that, if we give our young people access to mental health provision from a young age, that stigma will not grow in them as they become adults and they will be able to discuss mental health with their families, especially those families who we know need help and support? Because there is stigma in those communities, those children are not able to discuss that.

Bridget Phillipson: My hon. Friend makes an important point. It is incredibly important that we tackle the stigma that exists. That should be on a genuine cross-party basis. It is in all our interest that we make it as easy as possible for people to come forward and get the help they need. Sadly, even when people are able to come forward because they recognise they are struggling, they will wait years sometimes even to be seen. That cannot be right and that is why, under our motion, we would use some of the money raised to make sure that all our children get the mental health support they need as quickly as possible.

Alex Cunningham: Will my hon. Friend give way?

Bridget Phillipson: I will just make a little more progress, if my hon. Friend will allow.
Our motion will also task the committee to consider how the money raised by ending tax breaks could deliver the careers advice that young people so desperately need. Two thirds of young people do not have access to professional careers advice. Pre-pandemic, almost half of young people reported that they felt unprepared for their futures. Half of employers reported that young people were leaving education unprepared for the world of work. The Government are failing to support young people, and that is failing our economy, too. Their illogical plan to scrap Connexions has left a gaping hole that Labour will fill. We will invest in more than 1,000 new careers advisers and embed them in schools and colleges across the country, stepping in where Conservative Governments have failed.
This week, I spoke to some of the biggest businesses in the country. They told me that they struggled to engage with schools around careers and jobs of the future. They are concerned that teachers do not know what opportunities exist now and will exist in future. They worry that young people are not getting the access to the opportunities they need. Just as they step in to compensate for our struggling mental health service, teachers are also doing their best with careers advice, but it is not the job of teachers to fill this hole. I want our teachers free to focus on ensuring the highest standards in our schools, delivering opportunities and making learning fun. For a decade, this Government have piled more and more responsibilities on to our teachers. It is time to let teachers teach.
By expanding a network of professional careers advisers across our schools and colleges, we would free up teacher and lecturer capacity, and we would give young people the expert support they need to make informed choices about their futures and to learn about apprenticeships, T-levels and vocational opportunities, alongside the higher education options available to them. We would go further and introduce a minimum  of two weeks’ work experience for every young person, opening up new opportunities, enabling young people to explore their interests, build confidence and develop the skills that employers tell us they desperately need.
While Government neglect is leaving young people unprepared for their futures and the world they will inherit, Labour is facing the future. We want to meet the collective challenges that we all face—the digital shift, climate change and automation—and that starts in school and must continue with learning throughout all our lives. Labour’s plans will embed mandatory digital skills across the curriculum to make sure that no child leaves school without the basic digital skills they need for the modern world. Our plans will ensure that young people in school and college today leave our education system ready for work, ready for life and ready to grasp the opportunities of the better-paid jobs of the future. This is what aspiration for our children looks like: creating opportunities, driving high standards and delivering excellence for all, and that is what parents want from Government, too—not parroting lines from the independent schools lobby, but standing up for children and their life chances.
It is clear that the Government’s arguments on private schools simply do not add up. Private school fees have far outstripped wage rises over the past 20 years. Boarding school fees now average a mammoth £37,000 a year. That is more than the average worker earns in a year and is beyond the reach of all but the very wealthiest in our society. Conservatives will turn to bursaries, but the Independent Schools Council’s own figures shows that a mere 8% of children get means-tested fee support. The partnerships with state schools that they use to justify this special status have gone down again this year.
Protecting private schools is not about aspiration for all our children; it is about ensuring exclusive opportunities remain in the hands of a privileged few. Government Members know that. Back in 2017, they committed to review private schools’ tax status if partnerships did not grow, because they recognised that it is unfair and unreasonable to ask the public to pay for opportunities that most can only imagine. What has changed in that time? I note that the Minister for Skills, the right hon. Member for Harlow (Robert Halfon), is with us today. When he was Chair of the Education Committee, he said that
“charitable status for most private schools is something that should come to an end. The monies saved by Government from these concessions could be used for more teachers”.
We agree, but what has happened since?
We know that the now Secretary of State for Levelling Up, Housing and Communities, the right hon. Member for Surrey Heath (Michael Gove), described the elite benefits gained by those accessing private education as morally indefensible. He said:
“That tax advantage allows the wealthiest in this country, indeed the very wealthiest in the globe, to buy a prestige service that secures their children a permanent positional edge in society at an effective 20% discount. How can this be justified?”
I agree with him, yet the Prime Minister, the Chancellor, and the new Education Secretary are too weak to stand up to the independent schools lobby.
It should be easy for the Government to support our motion today, because education is about opportunity—the opportunities we give all our children to explore and develop, to achieve and thrive, and to have happy and healthy childhoods. I was lucky to attend a great local state school when the last Labour Government were transforming education across this country and when my teachers were fiercely ambitious for me and my friends, because they believed in the value and worth of each and every one of us. I want every child, in every school, in every corner of this country to benefit from a brilliant state education, supported by a Government who are ambitious for all their futures. That is why we need private schools to pay their fair share and support every child across our great local state schools to realise those ambitions. Today, the Government have a choice: they can hide behind their vested interests, or they can finally stand up for excellence for every child. I commend the motion to the House.

Gillian Keegan: My mission is to make sure that every child in this country gets a fantastic education and every opportunity to make the most of their abilities. My expectation of excellence is the same whatever the type of school and wherever it is in the country. A good education is not a battle of this school versus that school—at its most basic, it means giving every child the means to find their place in the world. My job is to make sure that schools do that, and independent schools have a valuable role in delivering that.
By the Opposition’s own account, applying VAT to independent schools might deliver £1.75 billion more per year for schools. The key word in that sentence is “might”. I gently suggest that “might” could be over-optimistic, or even economically illiterate. The Government recognise that a good education is the closest thing we have to a silver bullet when it comes to making people’s lives better, which is why we are putting an extra £2 billion into our schools next year and the year after. This will be the highest real-terms spending on schools in history, totalling £58.8 billion by 2024-25. [Interruption.] I hear a few mumblings of “2010” from the Opposition Benches, so let me put that into context. When we took office from Labour, the spending was £35 billion per year. For those following the maths, that is a 68% cash increase.
Under this Government, schools will not need tax changes to receive extra money; they will not have to wait. Without that policy, they will be getting it from April this year, and even more—£2 billion, as opposed to an optimistic £1.75 billion.

Ruth Edwards: I thank the Secretary of State for giving way. It is a shame the shadow Secretary of State did not afford me the same courtesy—I thought a debate was an exchange of ideas. What the Labour party is actually proposing is to financially penalise parents for paying to educate their children. I would have thought that would affect the number of families who could afford to keep their children in the independent sector, and lead to an influx of children from the independent into the public sector. What assessment have the Government made of how much that would cost the taxpayer in net terms? My hunch is   that it would actually cost more than it would raise, and therefore not only would the policy not deliver for everyone, it would not deliver for anyone.

Gillian Keegan: I thank my hon. Friend for her intervention, showing her economic literacy in full. I will get on to explaining some of the figures.

Clive Efford: Will the Secretary of State give way?

Gillian Keegan: I am very happy to give way to the hon. Gentleman.

Clive Efford: This issue surely boils down to a moral argument. It is charitable status that gives independent schools their tax benefits, but what kind of charity requires a person to pay an average of £37,000 in order for it to benefit from tax breaks? Is that really a charity?

Gillian Keegan: There is the huge education benefit, but I think the hon. Member may have his maths a little wrong—I do not think the average is £37,000.
We are improving state-funded education, not undermining the aspirations or choices that parents have for their children. That is important. We are delivering a world-class curriculum for all schools, not attacking world-class institutions that secure international investment and drive innovation. We are driving school improvement, not driving small schools serving dedicated religious and philosophical communities out of business. We are providing the funding to schools that they need.
I am delighted that Labour decided to include school standards as part of this debate, as our record speaks for itself. In 2010, just 68% of schools were rated by Ofsted as good or outstanding, but we have taken that to 88%—hopefully the Members opposite are still following the maths—which is a vast improvement driven by the Minister of State, Department for Education, my right hon. Friend the Member for Bognor Regis and Littlehampton (Nick Gibb).
Moreover, the hon. Member for Houghton and Sunderland South (Bridget Phillipson) should join me in praising the work of this Government. Since we took office, schools in her local authority of Sunderland have gone from 67% rated good or outstanding to 91%. Meanwhile, 97% of schools in the Leader of the Opposition’s local authority now enjoy a rating of good or outstanding—I am sure he has thanked my right hon. Friend the Member for Bognor Regis and Littlehampton for his role in making that happen. The shadow Schools Minister, the hon. Member for Portsmouth South (Stephen Morgan), should also be grateful; when Labour was last in power, fewer than half of his local schools met that standard, but I am happy to share with the House that we have taken that dismal record and made it good—literally. Today, Portsmouth now boasts 92% of schools rated as good or outstanding. I want to take this opportunity to thank teachers, headteachers and support staff up and down the country for their incredible work over these years, as they have been the key drivers of this success. I can guarantee that we will not stop there.
Underpinning that record are improvements in phonics, where a further 24% of pupils met our expected standard in the year 1 screening. In just eight years from 2010, we  brought the UK up the PISA rankings—the programme for international student assessment—from 25th to 14th in reading and from 28th to 18th in maths.
We will continue that trajectory as we build on the ambitions of the schools White Paper, which will help every child fulfil their potential by ensuring they receive the right support in the right place at the right time. This will be achieved by delivering excellent teaching for every child, high standards of curriculum, good attendance and better behaviour. [Interruption.] Somebody opposite mumbles “13 years”—I am sure that schools are delighted with the improvement I have just outlined over the past 13 years. We will also deliver targeted support for every child who needs it, making it a stronger and fairer school system.
Let us focus on the independent school sector. We  are very fortunate in this country to be blessed with a variety of different schools. We have faith schools, comprehensive schools and grammar schools, to name but a few, all of which help to support an education that is right for children. The independent school sector itself is incredibly diverse. It includes large, prestigious, household names—in this House, we will all have  heard of famous alumni from Eton—but there are 2,350 independent schools, and not many of them  are like Eton. Reigate Grammar School, a fee-paying independent school that now charges £20,000 a year, once educated the Leader of the Opposition; like many in this category, it started as a local grammar and became independent. In fact, 14% of Labour MPs elected in 2019 attended private schools—double the UK average. I will be interested to see which of those hon. Members votes to destabilise the sector that provided the opportunities afforded to them.
As someone who did not benefit from such a prestigious educational background, I stand here focused not on the fewer than 7% of children who attend independent schools, but much more on the 93% who attend state-funded schools, as I did. As the Opposition wish to use parliamentary time on this issue, I would point out that the sector provides many benefits to the state and individuals alike. Independent schools attract a huge amount of international investment, with more than 25,000 pupils whose parents live overseas attending independent schools in the UK. As my hon. Friend the Member for Gosport (Dame Caroline Dinenage) pointed out, many could be working in our armed forces.

Jonathan Gullis: One of the greatest things I saw while working in the classroom, unlike those on the shadow Front Bench, was a scheme introduced under the Conservative Government by the former Minister for Children and Families, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), which provided looked-after children with scholarships and bursaries to some of the leading boarding and private schools across our country. Are schemes like that—giving those most deprived kids the very best opportunities—not under threat because of the Opposition’s dangerous ideological plans?

Gillian Keegan: Absolutely. We will always focus on the people we can help. The more people we can help through a diverse school system, the better.
The independent school sector also has an international presence, exporting services through campuses in  other countries. The independent sector includes many   settings that serve small, dedicated faith communities, some with lower per-pupil funding than state-funded schools.

Alex Cunningham: I am grateful to the Secretary of State for giving way. She said that she wanted every child to have an excellent teacher, and so do I, but two thirds of teachers are planning to leave the profession in the next two years because of unmanageable workloads. What is the Government’s answer to that?

Gillian Keegan: I am grateful to the hon. Gentleman. We have 460,000 teachers, which is more than we have ever had in our school system—in fact, 24,000 more. I am glad to introduce some facts to his argument.
The sector also includes special schools, where some places are state funded. That provides vital capacity for vulnerable pupils that could not easily be replaced. There are hundreds of independent special schools that provide world-leading specialist support to some of our most vulnerable children, whether that is hydrotherapy provision for children with physical disabilities; sensory experiences for children with autistic spectrum conditions or who are non-verbal; or invaluable one-to-one support for young adults with Down’s syndrome preparing to step out into the adult world.
Many hon. Members across the House will have someone in their family or know someone who benefits from those services, such as my nephew with Down’s syndrome and the son of my hon. Friend the Member for Guildford (Angela Richardson). More than 5% of children with an education, health and care plan rely on the provision offered by an independent school. Are the Opposition suggesting that we put VAT on those fees? Hopefully not—[Interruption.] I am delighted to hear that they would not as the policy evolves.
The Opposition’s proposed tax policy would create a number of different challenges across that diverse sector and the outcome is uncertain. The more affordable schools, many of which are former grammar schools, are likely to be at greater risk from an increased tax burden, and the closure of such schools would increase inequality and reduce choice for families. Many schools, when faced with a sudden hike in costs, are likely to seek to avoid passing on the full cost to hard-pressed families. Indeed, many might choose to reduce the bursaries and scholarships that broaden access to such places instead.
Almost 160,000 pupils at Independent Schools Council schools receive some form of bursary or scholarship. For clarity, Independent Schools Council schools represent only about half of independent schools, so the number of people receiving financial support is likely to be far higher. Any independent school closures or a reduction in bursaries would only increase the pressures on the state-funded sector. At the current average cost per pupil of £6,970, the projected cost of educating in the state-funded sector all the pupils we are aware of who receive some form of scholarship or bursary would be more than £1.1 billion. That does not factor in any additional capital or workforce costs to create places for those pupils.
In fact, research undertaken by Baines Cutler shows that, in the fifth year of the Opposition’s ill-thought-through policy, the annual costs would run an annual deficit of  £416 million. Yes, hon. Members heard correctly: the policy could end up costing money. That could have been a contributory factor to the last Labour Government, during their 13 years in office, armed with a calculator and the figures, not implementing such a divisive policy.

Bridget Phillipson: The Secretary of State referenced the Baines Cutler report. Can she clarify who were the commissioners of that report and who tends to cite its findings?

Gillian Keegan: I would like to clarify that the figures that I used—160,000 pupils times £6,970—are our figures, so £1.1 billion is our calculation. The Baines Cutler report was commissioned by the independent schools sector. Of course, everybody in the sector, as in many other sectors, commissions research, but I hope that the hon. Lady is not suggesting that, because the report was commissioned, it did not have to be validated—of course, it would be. [Interruption.] If she wants to understand, it would cost £1.1 billion at the current average cost per pupil £6,970. I do believe that that is why previous Labour Governments did not implement the policy, because it would greatly undermine the benefit of any additional funding to the state sector, and it could result in Labour’s proposed financial benefit in fact being a net cost to the Exchequer.
I remind right hon. and hon. Members that two thirds of Independent Schools Council members—almost 1,000 of them—are engaged in mutually beneficial cross-sector partnerships with state-funded schools. Those schools share expertise, best practice and facilities to the benefit of children in all the schools involved. I thank my noble friend Baroness Barran, who is in the Gallery, for her work with independent schools to emphasise and grow those partnerships.
To give one example, Warwick School and King’s High School have worked together to support students to prepare for assessments and interviews to highly selective universities. An increasing number of independent schools also provide subsidised places for disadvantaged children through the Royal National Children’s SpringBoard Foundation’s broadening educational partnerships programme.
I am sure that the shadow schools Minister, the hon. Member for Portsmouth South, will be interested in my final example, which benefits teachers in his constituency—he does not appear to be that interested, but I will try. The Hampshire Physics CPD Partnership provides fully funded professional development workshops targeted at specialist and non-specialist physics teachers to support teaching at key stage 3 and 4. The partnership includes many schools and colleges in Hampshire, including UTC Portsmouth.
The proposals do not make financial sense; they do not make sense to parents and they certainly do not make sense to children in the sector. The Labour party’s policy is the politics of envy. In this Government, we do not have to level down to level up; I am not somebody who resents other people’s opportunity. As many hon. Members understand, I went to a comprehensive school in Knowsley that I could not boast about in the same way that the hon. Member for Houghton and Sunderland South does, because it sadly failed generations of children.

Cat Smith: Will the Secretary of State give way?

Gillian Keegan: I will not give way; I think I understand my school better than most.
That is why I am hugely honoured to be in this role to support all children in any education setting to get the excellent education that they deserve. I do not want to level down anybody; I want to level up everybody. Our independent sector is a small but important part of our school system. It brings valuable international investment to the UK; it serves small, dedicated faith communities; it creates special school capacity; it drives innovation; it gives parents a wider choice; and its bursaries are a valuable tool for driving social mobility. We should not undermine that.

Andrew Lewer: My right hon. Friend is making an excellent defence of the independent sector and its partnership work. Does  she believe that Labour’s policy would also undo the fundamental principle that the UK does not tax the supply of education? Furthermore, there have been repeated references to “tax breaks” to mean simply not paying extra tax on top of the income tax that people already pay. That is a misleading description and should not be used to describe this ill-thought-out policy.

Gillian Keegan: I agree with my hon. Friend that there is lots that is misleading about the way the policy has been presented, and that the benefit of education is the reason it receives tax breaks.
It is not for the Government to determine the work of parliamentary Select Committees, but the motion proposes the setting up of a new Select Committee that would take up considerable parliamentary time and resources. If I am correct, the House published an estimated cost to the taxpayer of those Committees of £417,000, at the very least, in this calendar year alone. Furthermore, there is already a Select Committee empowered to look at these issues—one which I and my fellow Ministers regularly appear in front of—the Education Committee. I have no doubt that we will hear more from members of that Committee.
Our focus should rightly remain on improving standards at all schools, so we will continue to ensure that all state-funded schools have the funding they need to make sure every child receives the best education and opportunities possible. I remind Opposition Members of the £2 billion extra next year and the year after that was awarded in the autumn statement, as well as the figure for our overall spending on schools of £58.8 billion as opposed to £35 billion in 2010. We will continue to ensure all state-funded schools have the funding they need so that all children receive the best education and opportunities possible. This proposal is the politics of envy. It is pulling the rug from under good independent schools in a weakly veiled, politically motivated, economically incoherent policy which will not help our mission to ensure that every child can reach their potential. We as the Conservative party do not level down; we focus on levelling up.

Several hon. Members: rose—

Rosie Winterton: Order. Before I call the next speaker, let me say that I do not want to impose a time limit, but I urge colleagues to stick to a maximum of seven minutes per contribution.

Cat Smith: It is a pleasure to be called so early in this debate. Since we are in the business of declaring where we went to school, let me say that I went to a comprehensive school in Barrow-in-Furness. The Secretary of State said that she went to a comprehensive school in Knowsley, but I invite her to explain what her Government are doing for more than half of the children in Knowsley who are failing their maths and English GCSEs. She is very welcome to intervene on me and explain what her Government are doing for those children in Knowsley, if she wishes. Would she like to do so?

Gillian Keegan: I am happy to intervene. The hon. Lady may have heard me say that, when I was at school, 92% failed to get the minimum of four or five GCSEs. I look at those schools very regularly and, yes, that has improved massively since then, but it is still nowhere near good enough. We are very much focused on supporting those schools, on maths hubs and on introducing maths, free phonics and lots of things that will help in the early years, as well as the teaching support and the development of teachers. She is absolutely right that many in my family, including my cousins and my cousins’ kids, have been to schools in Knowsley, so like her, it is a very personal issue for me.

Cat Smith: I am really glad to hear that the Secretary of State takes such an interest in schools in Knowsley, but in Knowsley, as in many parts of England, we have schools where children are failing to reach their potential, and that is not because of a lack of will from the teachers.
This debate is a good opportunity to pay tribute to our teachers, our teaching assistants and the parents supporting children at home, who make sure that our kids get the best education possible, as well as—if I may stray a little bit beyond the debate—the youth workers. Where we still have them, youth workers also support children’s education in an informal environment. It is an environment post covid in which, frankly, it is truly remarkable the lengths that our teachers and teaching assistants have to go to make sure that our children can access such an education.
I want to put on record my personal thanks to the headteachers cluster in the Lancaster and Morecambe area, who consistently and persistently meet me and my constituency neighbour, the hon. Member for Morecambe and Lunesdale (David Morris)—we are meeting them again in a few weeks’ time—to ensure that, as Members of Parliament, we are aware of the challenges that schools face in the Lancaster and Morecambe area.
However, these teachers cannot continue to shoulder the burden for the Government’s failure. I would say that the education sector is in crisis, but we have now been saying that for many years, with no active response from the Government. The Government cannot continue to pretend that they are serious about investing in schools while the vast majority of schools are facing huge cuts, in spite of growing pupil numbers and costs. In Lancashire, 520 out of 564 schools face cuts this year, with £24.3 million needed to restore real-terms per pupil funding to its level last year. The staff who work in those schools desperately want to improve schools  and provide better for their pupils, but they need the Government to meet them halfway and to help them do so.
This debate is not just about one type of school, and I want to talk about rural schools. I have some small rural schools in my constituency, and I recently met Rebecca Scholz, who is the headteacher at Scorton Primary School in my constituency and Calder Vale St John Primary School. She is already struggling to make her small rural school budgets meet the needs of her pupils. Those schools do not have school halls, so they have the additional costs of hiring village halls for PE lessons. They do not have school kitchens, so they have to get school meals taxied in from schools further afield that do have kitchens. All of this puts additional costs on these small rural school budgets, and it is making it very difficult for Rebecca to ensure that these schools are sustainable.

Robin Walker: I entirely agree with the point the hon. Lady is making about small rural schools. For many years in this House I led the cross-party campaign on fairer funding—the f40 campaign—which pushed for the needs of rural schools. Does she not agree that key to meeting that challenge is reform of the funding formula for schools, which, sadly, is not mentioned in the Opposition motion?

Cat Smith: I am very well aware of the hon. Gentleman’s campaign, and I think there was a huge amount of sympathy for it, but his party has been in government for 13 years, so reform of the schools funding formula really does fall on his party’s shoulders. I would like to see that come from his own party.
This debate is not just about small rural schools. I have a three-form entry primary school in Lancaster that is facing cuts next year of £197 per pupil. Many such schools are obviously dealing with huge social issues as well as providing education. Schools in more deprived areas, where education can make a huge difference, are suffering an even bigger financial hit. Many of my constituents contacted me recently about the campaign to extend free school meals. There are around 800,000 children living in poverty who are deemed ineligible for free school meals. The Prime Minister was warned that pupils face a “bleak, hungry winter”, but as yet he has refused to extend free school meals.
I am equally concerned about the growth in the attainment gap, which was mentioned by the shadow Secretary of State, between the most disadvantaged and the most affluent. These are not just numbers; these are children who are being left completely behind by the system, and communities will feel these costs for decades to come. Policy choices in all areas have an impact on schools. When the health sector fails, young people come to school unwell, and more often than not their mental health needs are being left unmet. When a young person’s needs are not met in any sector, schools are left to pick up the pieces and they pay the price. In these incredibly difficult contexts, teachers are understandably exhausted, and now we are seeing what is in effect a real-terms pay cut for the vast majority of teachers. Frankly, I think that is an insult after the heroic work they have done for our children.
The thing is that people know this, so the persistent problems we are seeing with the recruitment and retention of teachers should come as no shock to the Conservative party, which has made teaching an increasingly undesirable and unsustainable profession. Thirty six thousand, two hundred and sixty two—that is the number of people who left the teaching profession in 2020-21. That is 36,262 people who were overworked and underpaid to such an extent that they felt that they were not able to continue. How many teachers must leave before the Government take drastic action? We need a Government who are on the same side as teachers. To invest in teachers is to invest in students, and to invest in students is to invest in the future.

Robin Walker: I rise more in sorrow than in anger about today’s extraordinary Opposition motion to create a new education Select Committee for the House of Commons.
I was recently elected as the Chair of the Education Committee, with I believe quite a significant amount of support among Opposition Members. I canvassed Members all across the House and spoke to them about the issues that are priorities for them. I made sure that in my campaign I was listening to Members on all sides of the House about the things they felt would make a difference to the education of children in this country and the things that fall within the remit of the Education Committee. I can count on the fingers of one hand—no, in fact, I can count on one finger—the number of Members who raised this issue as a priority for them. So I find it extraordinary that the Opposition have tabled a motion to make this the subject of an entire Select Committee all of its own, even more so given that their own members of the Education Committee are nowhere to be seen today.
I have great respect for the Opposition Members on my Select Committee, who do an excellent job in holding the Government to account and challenging on education policy issues, not least on some of the issues that the hon. Member for Houghton and Sunderland South (Bridget Phillipson) mentioned, such as careers information and advice. We are currently conducting an inquiry into that, which was started by the Minister of State, Department for Education, my right hon. Friend the Member for Harlow (Robert Halfon), who is on the Front Bench.
It seems extraordinary to me that, without any forewarning or any notice to the Chair of the Education Committee, the Opposition have decided to try to sideline the established mechanisms of this House and to sideline the Education Committee on this issue by creating an entirely new committee. There is absolutely no reason for that. I gently point out that the Opposition should be doing a better job of encouraging their own Committee members to engage. Sadly, I can count four Conservative members of the Education Committee in this debate, but there are none on the Opposition Benches. I suspect it is because they know that this policy is a shambles.
The net financial impact of raising the cost of independent education is likely to have a negative impact on the cost of state education, because it will drive up demand for places in a very constrained secondary sector. In my constituency right now we are pretty much full in the secondary space, and a new school is being  built by the local authority at a cost of around £40 million to meet our needs. If we were to raise fee levels for the two independent schools just in the mainstream sector, King’s and RGS, the chances are that many families would no longer be able to afford to send their children to those schools, and they would be looking for places in the secondary sector—places that are not currently there. There is a failure to understand and think through the consequences of the Opposition’s proposed policy.
I detect—and in conversations I have had with Back Benchers from all parties, I heard about it—the huge pressures on childcare. That is one reason I proposed that if I were elected Chair of the Select Committee we should do an inquiry into that issue—indeed, the shadow Secretary of State welcomed the fact that we are doing such an inquiry. I did not, however, hear the same demand and pressure from people saying, “We must do something to make life more expensive for people who choose to send their children to independent schools.”
When the Opposition talk about “tax breaks”, that is a complete misnomer in this respect. The charitable status of education has existed for well over a century. Every Labour Government from 1945 has supported the principle of the charitable status of education, and Labour Members ought to be honest about what they are trying to do. They can make legitimate arguments, and say that they believe independent education is a bad thing and they want to discourage it—if they choose to have that argument, they can have it—but the net result of what they are proposing for the independent sector would be to make it more elite and out of reach for ordinary families. The big names out there would no doubt continue to thrive, with wealthy families that can afford to pay and international students—that issue has already been mentioned—but many smaller independent schools might be driven out of business, and if that were the case, the cost of meeting those places and that demand will fall on the state education sector. As the Secretary of State said, that cost is more than £6,000 per pupil on an ongoing revenue basis, and there is also capital to think about and the extra classrooms and schools that will be required to meet that need. I do not think the Opposition have done their homework in that respect.
I understand from what the hon. Member for Houghton and Sunderland South said from a sedentary position to the Secretary of State that it is Labour’s intention to exclude the specialist independent sector from this policy, but when Labour Members look at their net revenue figure, they are looking at fees across the entire sector, including that specialist sector. I simply do not think they have done their sums. The focus of those on the Opposition Front Bench, as opposed to their Back Benchers—where are they all, frankly, in a debate of such importance to their party?—shows that this is not really about a serious policy for the school system. This is about an attempt to brand the Prime Minister and have a personal go at the leader of the Conservative party. I do not think that will wash with the great British public, and this is more about the politics of the playground than a serious schools policy.

Clive Efford: Will the hon. Gentleman give way?

Robin Walker: I will not give way to Opposition Members, because they have not had the decency to approach my  Committee or to speak to me as its Chair before putting down this extraordinary motion. I do not feel that I should have to give way to them during this debate.
I will continue to make the case for investment in education. As schools Minister, I was proud to be involved in negotiating the single largest increase in our schools budget on record in real terms. I am delighted that my predecessor and successor, my right hon. Friend the Member for Bognor Regis and Littlehampton (Nick Gibb), has secured an even bigger increase off the back of that.
The shadow Education Secretary did not appear to have read her own motion when she talked about mental health. We all agree that mental health is a huge challenge and something that needs to be addressed, but there is nothing whatsoever in the motion about mental health, or in the remit of the extraordinary new Select Committee that Labour is trying to create, that addresses that issue. Labour Members need to do their homework before they come forward with such proposals. I am sure my Committee will be happy to consider any serious proposals that come forward, but this ain’t it.

Lyn Brown: I am worried that this Government are becoming dangerously complacent about the situation in our schools. In Newham we have many bright and ambitious children who achieve so much despite all the difficulties, and I am going to talk about that today. Newham has the second highest child poverty rate in the country, but nevertheless attainment is well above the national average. We are seeing many brilliant young people going on to universities—top universities—and contributing so much to our economy and society. What a testament to the ambition of those families, to the ambition and commitment of those children and, most of all, to the commitment and ability of those teachers. However, one headteacher in my constituency told me just yesterday that she and every other headteacher she knows is either already running a deficit budget, or expects to do so, so that achievement is at risk. Let’s face it: the failures of 12 years of Tory policy are having the biggest impact on the most vulnerable individuals and families, with lifelong consequences for them, and a real cost to our economy.
Let me remind some Conservative Members what “most vulnerable” children means. This is about children going to bed hungry, in small, damp, mould-crusted flats. It is about children who are not able to learn in school because they do not have the support they need with their special educational needs or disabilities. It is about children who are vulnerable and who, in the absence of support, can sometimes be disruptive to the learning of others. When class teachers do not have specialist staff to help with those children’s individual needs, that forces them to work even harder, and the learning of all the children suffers as a result.
In Newham there is a backlog of up to 18 months for children who need an assessment for an education and health care plan. One of my constituents was told that they would have to wait two years—a completely unbearable length of time—while their child struggled at school without the support they needed. So my constituent went to family members and borrowed money to pay for a private assessment. It is just like with private  healthcare—the consequences of Tory failure can be avoided, but only for those who can somehow find the money to pay their way out of the system. In many areas such as Newham where poverty is rampant, children and schools are having to do their best without specialist support or the much-needed resources attached to EHCPs. Even when a family manages to get that assessment and an EHCP is drawn up, funding falls well below what is needed to meet assessed needs. I have been told of one local case where the actual cost of meeting a child’s needs was estimated to be almost four times higher than the funding on offer for their plan, and it is the same for other social care needs.
Our schools have a massive role to play in getting children early help against gang grooming and county lines. But children’s services are so overstretched that when our schools make referrals, they tell me they are being turned away unless the situation has already escalated to the point of police involvement. That is a waste of money, if nothing else, and it is certainly a waste of my children’s lives—literally. I hope that all hon. Members will understand that waiting for police involvement means that it is often way too late to stop a child’s life spiralling out of control into further chaos and crime. Instead, schools are told they have to support needs that have little to do with learning, and they simply do not have the expertise or the resource to be able do so.
When we look at these issues, we see that of course they are about teacher shortages and crumbling school buildings, but we also need to look at the wider social and economic barriers that are so damaging to children’s learning. What about housing? In Newham, 8,363 children are without a stable home—they are in temporary accommodation. Lower quartile earnings in Newham are £1,451 a month, but the lower quartile private rent on a two-bedroom home is £1,400 a month. Someone could spend all of their earnings just on getting a roof over their head without even thinking about energy or all the other bills that are massively increasing. So, according to the Government’s own data, we have almost 3,500 families without a stable home and in temporary accommodation.
From schools, I hear about children who are effectively living in one heated room, with the whole family huddling together for an evening. Obviously, trying to do homework in those circumstances is impossible, so we have children staying at school as late as they possibly can. It is so different from when I was growing up. I can say with confidence that without the stability of my family’s council flat, I would not be standing here today. We were not having to move constantly or to travel long distances because we had yet again been kicked out of a house.
What about food? Food insecurity has tripled from pre-pandemic levels, which in Newham were appallingly high. I am hearing directly from schools about children whose one decent meal a day—possibly their only meal a day—is coming from their school lunch. Why are we not providing that? Why are the Government not providing free school meals to enable children to concentrate throughout the school day without that constant nagging hunger? This is a wealthy country—I am told. How can we justify children’s life chances being held back because their families cannot afford food?
Even though Newham’s children come from London, they face many barriers. We need to tackle all those factors if we are ever going to truly level up. Instead, the social problems get worse because of Tory failures that go way beyond their failure with the school system.
Looking at all these additional stresses and needs, we come to the fundamental issue of core funding for schools. My understanding is that more than 8% of our state schools were already in deficit before the cost of living crisis, and the pay rises needed to manage it are having to be met from existing budgets. My schools tell me that they simply cannot afford to recruit new staff. That is affecting all our children, but particularly those with special educational needs and disabilities, whose needs simply cannot be met within existing resources. Let’s face it: the situation with staffing was already difficult before the cost of living crisis. In 2020, Newham had the second highest rate of spending on secondary supply teachers. How can we expect the skilled workforce that we need to come forward from circumstances like this? How can we expect our hard-working, dedicated, professional staff to struggle on?
Earlier today the Prime Minister said:
“Everyone should have the opportunity to succeed.”
But to will the ends, he must provide the means; otherwise, those are simply empty words, signifying nothing.

Simon Hoare: It is a pleasure to follow the hon. Member for West Ham (Ms Brown), who spoke with her usual passion and great knowledge of her constituency. There are a few of us in the Chamber who cut our political teeth on, or were involved in, the 1997 general election campaign. For every problem that came before us, the Labour answer was the windfall tax. They would say, “The windfall tax will sort this, that and the other.” It seems to me that the shadow Secretary of State, the hon. Member for Houghton and Sunderland South (Bridget Phillipson), and her colleagues see the motion as the educational equivalent of a windfall tax to solve all the problems, which many of us are alert to and which need to be addressed.
The money raised—this £1.7 billion—will, according to the motion, go to
“the recruitment of new teachers, additional teacher training, and careers advice and work experience for all pupils.”
In speeches, we have been told that it will address mental health, deal with SEND, underpin TAs, deliver mandatory digital skills and extend free school meals. This is the windfall tax that covers everything. This is the goose that will lay the largest golden egg in educational history.
Let me share a secret with the House: maths is not my favourite subject—please do not tell the Prime Minister—but, by my calculation, on the sums suggested divided by the number of schools in the state sector who would be recipients of that funding, that amounts to about £53,000 per school, per year. That is on the expectation that the £1.7 billion remains a continual, but some schools will get smaller, some will close and so on. It is therefore an entirely false prospectus.
I think that the shadow Secretary of State must have read in the press that her leader is thinking of having a shadow Cabinet reshuffle and scratched her head to think, “What might get me on the front page of the  newspaper and to lead a debate?” May I say gently to her that it might have seemed a good idea in theory to have this debate, but the practice is not playing out.
I am a huge supporter of the Select Committee system—I happen to chair one and enjoy it—but we do not need another one to address the issues of what could be done to help education. I am sure that the Education Committee will look into it, if that is what its work programme wants to do—[Interruption.] But let me set out my stall. I will yield to no one in my support for state education in our country. I went to what Mr Blair as Prime Minister would have called a “bog-standard comprehensive” in Cardiff. Of my three children, one goes to a church primary and the others go to one of our local high schools. They are receiving excellent education from first-class teachers. I have been a governor of two state sector schools and my wife is a current school governor, because we understand entirely that education provides the keys that are going to unlock all of life’s doors.
Conservative Members believe in a meritocracy. We are far more interested in where people are going than from where they have come. The motion—this idea—is all about class envy. It is all about divide. It is all about pulling down. May I say gently to the Opposition Front-Bench team that we do not improve things that need improvement by pulling down and reducing the excellent. We should be focusing on fostering that which lots of schools already do. There is a good example in my constituency: Bryanston, which is a leading independent school, teamed up with Blandford School, sharing resources and expertise in a whole load of areas to the improvement of children and their educational experience. That is what we should be focusing on, not pulling down something that is working. The effect on global soft power from the experience of coming to the UK, which the independent sector provides for so many young people, is always overlooked when we come to this debate. It is a very important tool in our arsenal; we must not forget it. We need to focus on those important issues. Nobody in my constituency says, “You are going to make my school better by stopping that school having VAT relief and charitable status.” They want to know what the Government are going to do to make their schools better and the attainment of their kids better. They are not motivated by this narrative of envy, and it is a shame that the House is being invited to be so today.
The motion presupposes that it will be of no cost to the public purse, but a conservative estimate suggests that about 100,000 children would be taken out of the independent sector and put into the state sector. That would have a cost, as my hon. Friend the Member for Worcester (Mr Walker) indicated, on already pressured state places, particularly, although not exclusively, in the secondary sector. Bursaries and scholarships would be removed. Who benefits? Nobody, apart from a narrow class interest suggested by some Opposition Members and certainly not shared by those on the Government Benches. I do not believe it is shared in the country either.

Ian Byrne: This is an important debate on how we can fairly tax private schools to raise funding for measures that are needed to improve educational standards in the state sector. Hundreds  of constituents in Liverpool, West Derby, including many educators, have contacted me about improvements they want to see and specifically on the issue of hunger in the classroom. I would like to represent those concerns in this place and speak about the difference that universal free school meals—a nutritious, free school breakfast and lunch for all children in primary and secondary state education—would make by improving children’s education, health and happiness.
Food insecurity levels have doubled since the start of 2022 and an estimated 4 million children are now going hungry in the UK. That includes many thousands in my constituency of Liverpool, West Derby, where the relative child poverty rate is significantly higher than the national average, in a city where one in three people are in food poverty. Food prices have increased by 16.4% in the year to October and healthier foods are now nearly three times more expensive than less healthy foods. That is devastating for children across the country and their families, including the many who are hungry but do not meet the Government’s eligibility criteria for free school meals. They are part of the 800,000 children nationally who are below the poverty line, yet still do not qualify.
Food poverty leads to health and life expectancy inequality, malnutrition and a host of related health problems. It affects children’s educational attainment and life chances. When asked about children coming to school hungry, 88% of teachers reported pupils being excessively tired and 84% reported that they are easily distracted. Less measurable, but no less important, is the effect on individual human dignity and social cohesion over time. As was reported by School Food Matters, nutritious school meals are linked to good mental health, wellbeing and educational attainment. Research found that over half of teachers felt that children who come to school hungry display anxiety. It is not just the hungry children themselves who are affected; half of all children say that they feel upset that some children do not have enough to eat at school, so this is also affecting children who are being fed.
Through fairer taxation, the Government could invest in a roll-out of universal free school meals. Findings from the Government’s own pilot noted improved educational attainment, with children making between four and eight weeks’ more progress in maths and English. Crucially, universal provision removes all stigma from school food and ensures all children have an equal opportunity to thrive and be healthy. The Government’s adviser, Henry Dimbleby, said:
“When children sit down to eat with friends and teachers in a civilised environment, it cements relationships, helps them to develop social skills and reinforces positive behaviour throughout the day.”
Backing that up, we heard powerful evidence at recent sittings of the Environment, Food and Rural Affairs Committee about the benefits and how this investment would more than pay for itself in the long run.
A cost-benefit analysis of universal free school meals by PwC shows the undeniable societal and economic benefits. If the Government made the investment, the core benefits over 20 years of providing universal free school meals would be £41.3 billion, compared with a total cost of £24.1 billion. The core benefits are savings on food costs, health and school spending, and increased lifetime earnings. There would also be £58.2 billion in  wider economic benefits, meaning that the total benefits from an investment over 20 years would be £99.5 billion. Yes, that’s right: something that is so needed and that is morally the right thing to do would give the taxpayer a return of £100 billion. It’s a no-brainer, whatever side of the political ideological divide you sit on.
We need political leadership in the Government that guarantees and realises the right of all our children to healthy food. If we accept the universal and compulsory requirement that all children up to the age of 16 be in school, why do we break from that principle of universal care, nurturing and protection in relation to their meals during the school day? We would think it absurd if children were not provided with adequate shelter, heating, drinking water and sanitary provision while in school, so why take a different approach to the equally essential element of food?
Today, we are literally consigning our most vulnerable children to a lifetime of poor life chances, ill health and low life expectancy from a lack of suitable food. That is not why I am in this place. Surely, we are all here to change that. Political choices define our time here. I implore the Minister to make the right political decision and invest in universal free school meals for every child in this country to give them the opportunity of a long, healthy and fulfilling life. They deserve nothing less.

Brendan Clarke-Smith: I start by expressing a belief that I hold and that many other Conservative Members hold, which is that education is a necessity, not a luxury. What we have today is all about ideology. It is not a pragmatic approach and it fails to understand how our school education system actually works. To stick VAT on school fees and end charitable status would have a devastating effect on the independent sector. This is very much an attack on aspiration itself.
My experience, like that of my hon. Friend the Member for North Dorset (Simon Hoare), is of going, back in the day, to what one might call a bog standard comprehensive. I became a teacher. I taught in the state system and in independent schools. For a short time, I was also the principal of a small independent school. Many parents were not super-rich people, but they all had something in common: they wanted to give their children the very best opportunities and a better life. Whatever their income and situation in life, that is what parents want for their children. Many parents make huge sacrifices—some working second jobs—to put their children through these schools, and we need to recognise that.
Today seems to be all about money, so let us look at the point that private schools actually save us money. The Daily Mail reported that they add about £16.5 billion to the economy—an alien concept to the anti-growth coalition, as we would call them—and that there are 328,000 jobs in independent education. To put that in context, that is as many as Asda, Sainsbury’s and the Co-op combined. Private schools pay £5.1 billion in tax contributions—enough for about 150,000 nurses, I believe —and save the Treasury about £4.4 billion in state-funded places. Of course, if children were not in independent  schools, they would need to go to state schools. We could end up with a situation where we have 90,000 children leaving and having to be accommodated in the state system.
We have two outstanding Outwood academies in Worksop in Bassetlaw, which I represent. We have deprived areas where children are given great opportunities due to our academies programme—something else the Labour party opposed. Both schools are heavily oversubscribed. Outwood Academy Portland is being expanded, which we really welcome, but that is happening without an extra influx of people coming in from the independent sector. Imagine if, all of a sudden, all the extra kids came in from the independent sector. What would happen? It has already been mentioned: we would need to find extra school places. All that would happen is that local children would not be able to find a place in their local school. There would be far more competition for the available places, and we would need to find somewhere for those children as well.
The Opposition motion would benefit nobody. My Labour council’s local plan includes building 12,000 houses, but it does not really have any plans for infrastructure and it does not seem to know how to collect money off developers through the community infrastructure levy. We were already concerned about the impact on school places, even without Labour’s plan. If a Labour Government were to introduce what the Opposition have suggested today, it would put further pressure on people who want an outstanding academy education for their children.
Independent schools do a huge amount for our community. The Independent Schools Council’s “Celebrating Partnerships” report highlights the work of Worksop College, a large independent school in my constituency that does wonderful work with 11 local state schools. It does chemistry roadshows, park runs and all sorts of activities; I praised its work in the House to the former Minister for School Standards, my hon. Friend the Member for Worcester (Mr Walker), who was very kind in his remarks about it.
A report commissioned by the Independent Schools Council suggests that if charitable status were removed, many schools would be able to reclaim VAT on their capital and building works. That would benefit larger and wealthier schools more than small, single-sex junior or all-age day schools, and it would potentially mean the Treasury having to write cheques for millions of pounds. I am sure that that is not the intention behind the motion, but I am afraid that it is a possible consequence.
Approximately 200 private schools with 26,000 pupils could be forced to close, and hard-working parents on lower incomes would be hardest hit. There would be a negative effect on bursaries and scholarships. Independent schools would become the preserve of the super-rich, who would be the only people who could afford to send their children to any of them. The schools, of course, would simply fill their places, where possible, with children whose parents were paying full fees. The damage would be to aspirational parents—the ones who are trying their best and the ones whose children are on bursaries and grants.
I am sure the Opposition believe that private schools are simply for posh people who want to send their children to Hogwarts to train as wizards or whatever, but the reality is that independent schools take all  different forms. It is about parental choice. Private schools also sponsor academies, which is a great way of ensuring that all children, whatever their background, get an outstanding education. Improving education for all does not have to come at the expense of others. It should be about aspiration, opportunity and partnership, not the envy, ideology and bitterness that we see on the Opposition Benches.

Emma Hardy: As I mentioned in my intervention on the shadow Secretary of State, I served on the Education Committee in the last Parliament. I had a very positive relationship with the then Chair, the right hon. Member for Harlow (Robert Halfon), who I see has now made it to Minister. With respect, I have to say that it is disappointing that the current Chair—the hon. Member for Worcester (Mr Walker), who I endorsed for the position—gave such a partisan speech. I would have thought that one of the main bonuses of being a Select Committee Chair rather than a Minister was having the opportunity to hold the Government to account and question them, rather than blindly following and endorsing everything they say.

Robin Walker: I am absolutely delighted to hold the Government to account and indeed to criticise them, as I have been known to do in the past. However, I gently say to the hon. Lady that what we are debating today has nothing to do with Government policy; it is about a proposed Opposition policy with which they want to sideline the Education Committee. That makes me angry, and I think it should make the whole Committee angry.

Emma Hardy: I do hope that the hon. Gentleman will exercise his new-found freedoms as Chair and make the full transition from parliamentary supporter of the Government to parliamentary ambassador holding them to account.
Some incredibly impressive straw men have been conjured up in this debate, including the faintly ludicrous idea that if we prevent independent schools from being charities and from being funded partly by the taxpayer, they will suddenly all close, everyone will suddenly come to the state schools and it will be a tragedy that costs our state sector so much money. What utter nonsense! The average cost of an independent school over a child’s education is £270,000, so I hardly think that parents will be running for the local comp if those schools suddenly stop having charitable status.
This year, private school fees are set to rise by 7%. If the Government’s ideas were logical, we would therefore expect a reduction in the numbers attending private schools, but what is happening? At exactly the same time that fees are rising by 7%, we are seeing no suppression of enrolment; in fact, the numbers who wish to enrol are increasing. This idea that numbers will suddenly decline if we make private schools stop being charitable institutions and start paying a fair amount just does not stand up.
I thank all the schools, teachers and school staff in my constituency. Schools do so much more than just educating children. I will briefly mention one school: Chiltern Primary School. If the Secretary of State ever visits, I hope that she will have a look at the work that Chiltern is doing. Every Thursday, it does something  called Chat and Choose: parents line up and pay £1 for six items of food, which they can collect from the school, and a professional is there at the same time to advise and support them. That is an absolutely excellent example of a school doing so much to support the wider community. I put on record my thanks to Chiltern for its work.
Politics is always about priorities. Given the state of the economy, thanks to 13 years of Conservative Government, I am slightly surprised that the hon. Member for Bassetlaw (Brendan Clarke-Smith) chose to cite the last Prime Minister, who did not do particularly well with our economy, as someone whose recommendations we should follow. We have a choice. What will we choose and who should we choose to invest in?
In my earlier intervention I mentioned SEND, which is a real passion of mine and of the right hon. Member for Harlow. One priority that our Committee identified was the need to give teachers more training in SEND support. I was a teacher for 11 years: when I first started, I was not adequately trained to fully support all pupils with SEND. One possible use of the £1.7 billion is supporting teachers in that way. I would hope that that was a priority for whichever party was in government.
I want to mention oracy: speaking and listening, which the Schools Minister—the right hon. Member for Bognor Regis and Littlehampton (Nick Gibb), who has returned to his place after a short break—has heard me mention before. Spoken language is one of the strongest predictors of a child’s future life chances, but it is often overlooked and undervalued. I chose to prioritise it when I was a teacher by giving children opportunities to talk. I even set up a little debate club for year 6 pupils in my primary school. At the time, a parent said, “Why are you doing that in a comprehensive? That’s for the private schools.” No: debate, discussion and holding your own in a conversation should not be a skill learned just in private schools; it should be taught in all schools.
Oracy is not just about making everybody an Oxford-standard debater. It is more than that; it is about helping people with communication difficulties, supporting people to become more active citizens, and giving people social support and confidence. The Education Endowment Foundation has found evidence that oral language approaches in schools have a very high impact on pupils’ outcomes and a very low cost. In fact, six months’ additional progress can be made over a year when pupils are supported with oracy.

Margaret Greenwood: I do not want to take up too much of my hon. Friend’s time, but she is making an excellent point: oracy is really important. Before Christmas, I met Wirral primary school headteachers and their representatives, who stressed the financial challenges that their schools face. The things they are finding it difficult to pay for include speech therapists and mental health support for children. Does my hon. Friend agree that we cannot afford not to give schools that support, because it is essential for our young people?

Emma Hardy: I absolutely support my hon. Friend, who is a tireless champion for schools and educators.
I also want to mention social confidence. Oracy helps students to get along with others. It gives them support with so much more than just academia. It helps them to  engage with democratic society and the democratic processes. I hope we will remember that when we look at our priorities, at what we value and at where money can best be spent to support the majority of people.
I do not think private schools are going to close overnight if their charitable tax status is suddenly removed. What I do think is that the money could be invested to support more pupils, and I hope that by doing that we could help every single child in the country, not just those whose parents can pay £270,000 for an elite private education.

Jonathan Gullis: Let me start by saying—although she may not like it—what a tremendous fan I am of the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy). Unfortunately, however, in this instance I think she has missed the mark. While I absolutely respect the fact that she, like me, was on the frontline of teaching in state schools across our country, dealing with some of the most disadvantaged pupils in our communities, I need to make sure that she understands people like me.
I went to an independent school because my mother got off the council estate in London through grammar school after her father, a postman who died when she was 17 years old, and her mother, a local teaching assistant, put all the money they could into giving her the very best start in life with a tutor. My father, who had failed his O-levels, went back to school to be a cleaner during the day, then took night school classes and worked his way up, through the Open University, to be the first member of my family to hold a degree. If it had not been for my lifelong-supporting stepfather, who decided to invest in me, his non-biological son, I would not have had the privileged education that I was able to receive. So to try and make out that my family, who did not have holidays, new cars, house upgrades or extensions, but who decided that they wanted to invest in my brother and me to make sure we had the very best education, were simply some super-rich family—well, that is for the birds.
Yes, we were middle-income earners, and yes, my brother and I did not face the hardships that my mother and father had had to face, but to portray in that way any parent who aspires to enable their child to go to that type of school and has the money to do so is simply wrong. I walk around Stoke-on-Trent, North, Kidsgrove and Talke meeting parents who work on the shop floors of our local ceramics manufacturers, who are cleaners in local domestic households, who are workers in microbusinesses hiring maybe two or three local people, and who choose to spend their money in schools such as Edenhurst or Newcastle-under-Lyme, because that is their right, that is their choice and that is their money—while also paying their taxes on top, which funds the state education sector. It is completely wrong to portray such people in that way.
I find it astonishing that the vast majority of Opposition Back-Bench speakers have not actually addressed the motion, which proposes the establishment of an Education Committee 2.0, with a Chair who I am sure they believe would agree with their views, and with members who  would obviously have a predetermined conception of what they wanted the outcome to be and would obviously come up with the result that they wanted. When I was a teacher, we certainly did not teach children to answer questions like that in exams, because it would have been the wrong thing to do; the idea was to have the ability to look at all sides of the argument and understand it.
I find it astonishing that we are having this debate, and that Opposition Members, despite praising the current Chair of the Education Committee, my hon. Friend the Member for Worcester (Mr Walker), as the shadow Secretary of State did, are saying to him, “You are doing a good job on childcare and we like what you are doing on careers, but because we are worried that you might not just agree with our policy we are going to try and set up a side-Committee—but, by the way, none of our Education Committee members agree with us, because they have voted with their feet and not turned up for the debate.” They have not even asked the Chair of the Education Committee to put forward his views in either a public or, I assume, a private session. If minutes can be provided to prove me wrong, I will be more than happy to be shown them.
This demonstrates yet again that we are here for purely ideological reasons. The maths simply does not add up—that is why the Prime Minister is absolutely right to want more pupils to study maths up to the age of 18, and I suspect that the Labour party should be the subject of a pilot study for this scheme to make sure that we show how it works and their sums add up.
As has been explained so beautifully by other Members, the scheme will come at a cost to the taxpayer. Some private schools, though not all, will close, and therefore some pupils will need other places. In Stoke-on-Trent we have no secondary school places available to fill, so there will be a cost to the Stoke-on-Trent taxpayer, as kids will be bussed out of the local area to neighbouring schools, although it may not be clear whether they themselves will have spaces. That will put more pressure on teachers at a time when they are still recovering from the covid pandemic.
Labour seems to think that new teachers will magically appear, although they have to go through a year of training and recruitment. That is challenging not because of Conservative rule, but because the likes of Opposition Members are telling me and others, time and again, how terrible teaching is—how terrible the conditions are, how terrible the classrooms are, how terrible the children are to work with. Is it any wonder that people do not turn up and ask to be teachers, when an advert over here is telling them that teaching is the worst profession in the world to work in?
I speak as someone whose partner is a former Labour party member who fully supports what the Conservative party has been doing to raise educational standards with a knowledge-rich curriculum and strong behavioural expectations. I have seen the same in schools with Labour-supporting headteachers, such as Kensington Aldridge Academy, right at the foot of Grenfell Tower, who have done excellent work to ensure that a rigorous curriculum gives children the chance to go to university. I think that, last year alone, six to 12 students went to Oxbridge from that school in that deprived part of Kensington because of the tremendous work of—yes, those friends: obviously, I declare my interest. That shows what this Government have done, time and again, to deliver for those people.

Anna Firth: My hon. Friend is making a fantastic speech. According to the PISA—programme for international student assessment—tables, literacy and maths skills plummeted under Labour. We went from seventh to 25th in reading and from eighth to 28th in maths, and it has taken successive Education Secretaries and hard work from Ministers to recover from that position. Does he agree that before applying their big-state, freedom-stripping, economically illiterate ideologies to education, the Opposition should first get the basics right?

Jonathan Gullis: I fully concur with my hon. Friend. The simple truth is this. Even the Chair of the Business, Energy and Industrial Strategy Committee, the hon. Member for Bristol North West (Darren Jones), told students at one of his local private schools, Redmaids’ High School, that he did not agree with this policy. Behind closed doors, the Labour Chair of a Select Committee says one thing while Labour Front Benchers say another.
This is not just about money; it is also about jobs. It is about the caterers, cleaners and groundskeepers who will lose their jobs if these schools close, and it will not necessarily be easy for them to find jobs to replace them. It is this Conservative Government who have introduced the successful multi-academy trusts and phonics; literacy and numeracy are up; and the disadvantage gap had narrowed before the pandemic. There is £7.7 billion from the spending review, and an extra £4.4 billion from the autumn statement. The Conservatives are on the side of teachers, on the side of parents and on the side of pupils. It is a shame that the Labour party is not.

Munira Wilson: The whole argument about how we tax private schools is underpinned by a much more important question: why do so many parents choose to send their children to private schools? Some parents, particularly those whose children have complex special educational needs, feel that they have no other choice, as Government cuts in council funding mean that councils often struggle to provide the support that their children need. Others look at the sports, art, music, drama, debating skills, coding clubs and other opportunities that private schools offer, to a far greater extent than could be dreamt of by many of our state schools. They see that the pupil-teacher ratio in private schools is half that in state schools, as the Government fail year after year to meet their own teacher-training targets. They see that a private school has an on-site counsellor, when their child has been waiting months, sometimes years, to be assessed by child and adolescent mental health services and subsequently treated if they need help.
As the Government continue to let our pupils down, having failed to invest properly in covid recovery, we cannot blame parents for wanting the very best for their children. However, the Government cannot brush off criticisms of the status quo as an attack on aspiration. They know just how badly distorted the playing field in our education system is distorted.
At the root of the inequalities I have outlined is money. According to the Institute for Fiscal Studies, the average private school fee is £6,500 more than state school funding per pupil. More than half of private schools are charities, required to operate for the public  benefit, yet current case law allows private schools to decide for themselves what that public benefit is. It lets some private schools get away with the bare minimum. Others, on the other hand, are doing far more.
In October, I attended the launch of Feltham College in a neighbouring constituency. It is a new sixth form run out of Reach Academy in Feltham, which is an inspirational school founded by an inspirational man called Ed Vainker, who happens to be a constituent of mine. Reach is run in partnership with Hampton School in my constituency and Lady Eleanor Holles School, also in my constituency, as well as in partnership with Kingston University and various other partners. The two independent schools offer 28 taught periods per week across a range of subjects, particularly the sciences. The teachers from LEH and Hampton have also offered additional tutoring and coaching sessions for students at Reach who want to apply to Oxbridge or to medical school and need to go for interviews.
The partnership is producing results: students at Reach achieve the best chemistry and biology results that the school has ever had. Children and young people from some of the most disadvantaged backgrounds in an area that historically has sent far too few of them into higher education are seeing the most extraordinary results. I want every private school to offer that sort of support to the state sector, not by imposing top-down solutions—as some previous Education Secretaries have attempted—but, rather, by partnering with neighbouring state schools to identify needs in the local community and to share resources and expertise effectively.

Sarah Owen: The hon. Lady is making an excellent speech. I wholeheartedly support some of the work that she has outlined around partnerships. Does she not agree that, fundamentally, this goes to the heart of how we see education: education is not a charity but a fundamental basic right?

Munira Wilson: I agree that education is a fundamental basic right. I am about to talk about the nature of charitable status. It should not be seen as a club. Some private schools perhaps do operate in that way, but lots do not. The hon. Lady goes to the heart of my point: if we are to give private schools charitable status, they need to do much more across the board to earn and to keep that status. We should expect the level of collaboration I have outlined between Reach, Hampton and LEH. We should expect that sort of collaboration from every school with charitable status. A charity is not a club. It should not use resources to benefit only its own members, even if it occasionally waives the entry fee. If it does, the Charity Commission should have the power to revoke its charitable status.
I also believe—this point has been made by some Members—that education is a public good. Our VAT system recognises that essentials such as food and healthcare should not be subject to additional taxes. Currently, all education provided by eligible bodies, including schools, universities and providers of English as a foreign language, are exempt from VAT. That is important because it is a statement that education—however it is provided—is as much a public good as bread, eggs and cheese.
I am in politics because I am passionate about education. The importance of education was instilled in me and my sisters from a very young age. I believe that every child, no matter what their background, should be  given the opportunity to excel and flourish in life, because every child has something special in them that we need to draw out.
That is why I believe, and Liberal Democrats believe, that education is an investment in our children’s future and our country’s future. We want every parent to be able to send their child to a good, local school where they can fulfil their potential. Parents want a fair deal from their local primary or secondary school. Liberal Democrats want that, too. We want a qualified mental health professional in every school; opportunities for every child, no matter their background, to take part in music, sport, drama, debating and so on every day; a recruitment and retention plan to attract the very best teachers, not to burn them out within five years. We want properly funded local councils that will tailor support to a child’s individual and complex needs, rather than parents having to go to court to secure their child’s right to support; and a hot meal for every child living in poverty.
That is what pupils need. That is what parents want. That is what Liberal Democrats will campaign for.

Flick Drummond: It is a pleasure to speak in this debate. Like others, I am very disappointed with this motion, as it completely distracts from the real issues in our schools, where we should focus on children’s outcomes rather than be obsessed by the ideologies that have no interest in how children perform in schools or the choice that every parent should have.
Interestingly, not a single Labour Back Bencher so far has spoken in favour of this motion, which looks more like something that has been drawn up by the Opposition Treasury team rather than the Education one. As others have said, the movers of the motion seem to have completely forgotten about the existence of the Select Committee on Education, of which I am honoured to be a member. What a missed opportunity. This could have been a chance to talk about reforming our education system—it is essential that we do so, as Ministers have heard me say many times before—and what sort of reforms we would like to see.
As co-chair of the all-party parliamentary group for schools, learning and assessment, alongside the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy), I have a lot to say on the subject. I want a state education sector that is so good that our families recognise it to be as good as or superior to independent schools. Making changes to the taxation status for independent schools would do nothing to improve the standards of state education.
We have known from previous exercises and dogma, such as the abolition of the assisted places scheme, that a Labour Government would go ahead whether or not its policy is in the interests of children. The abolition of the APS was an ideological measure intended to chip away at independent schools, and weakened the position of some. It played a part in the closure of some schools, but did nothing to improve the quality of education in this country, although it narrowed access to the independent sector for children from disadvantaged backgrounds. Now Labour wants to order yet another attack.
The introduction of VAT in education will mean very quickly that an estimated 615,000 children in the independent sector may need immediate places in the state system. Beyond that, the viability of many private schools will be weakened and they will close. It is likely to lead to a disorderly exit of provision from education in this country. There is no guarantee that the measures proposed by the Opposition would raise any additional money for the Exchequer; they could well cost the DFE more money than the Treasury raises.
The families of those 615,000 children already pay taxes to support the education system, yet it costs the education system nothing to educate them. The potential burden that Labour’s proposals would impose is a risk in itself. As the Secretary of State for Education said, the average spend per pupil is £6,900. That means that it could immediately cost over £4 billion to put each one of those 615,000 children into state school. As each school closes, the VAT return diminishes, teachers and other staff are made redundant, and who pays for all of those historic buildings? Some of them require vast sums to maintain.
Competition is already pushing at some independent schools where the state offer is strong. In recent years in my own part of Hampshire, we have seen Rookesbury Park School close because of falling numbers. Nearby in Portsmouth, as the Schools Minister, my right hon. Friend the Member for Bognor Regis and Littlehampton (Nick Gibb), will know, St John’s College closed at the end of last year for the same reason. The reason behind those closures was the improved state provision by this Government. In Portsmouth, we have Charter Academy, which replaced a totally failing comprehensive. It has won national recognition as one of the finest schools in either sector. Where there have been failing educational authorities, academisation has been transformational. Hampshire has a very strong education authority. Every school in my constituency is good or outstanding. In my constituency, I have no private schools at all.
What we should be debating today is reform, not more layers of scrutiny. It will be no surprise to this House that for me, an extended school day with a broader curriculum is an absolute must. It means more freedom for teachers to teach subjects in depth and not to teach to the test for the many kinds of assessments that we currently have. It means abolishing GCSEs, which in my view stultify education. We need to recognise that secondary education is a continual process to the age of 18, and what we currently ask of children at 16 is not beneficial. Education is key to the country’s continued prosperity. It is a key driver to lift people out of poverty and it must remain the focus of any Government. It needs consensus, not dogma. This motion achieves absolutely nothing.

Janet Daby: This is an important debate on improving school standards by changing the tax status of private schools. I will be focusing my remarks on the need to improve school standards. According to the National Education Union, 34% of children—more than 8,000 in my constituency—are living in poverty. This concerns me and it should be a concern to the Government because it is about the welfare of children. I commend the school staff in Lewisham East for all that they do to support children  to grow, learn and develop. The schools in my constituency all focus not only on a child’s learning; they go over and above to meet their needs. Headteachers, teachers, assistant teachers, school governors, parent teacher associations and other volunteers are absolutely remarkable. They do so much more for children and families. In some schools, they provide food packages for families; in others they are looking at improving their green spaces and making the streets much safer. In one school that I know particularly well, they grow their own food. They generally all have such a big heart to develop their schools and support the children and their families.
Every child in Lewisham East is unique, and so is every school as they strive to do their best, but we need equality for children from poorer backgrounds, and without proper funding, school standards will not improve. According to the House of Commons Library, schools in Lewisham East have seen an 8% decrease in per-pupil funding in the last nine years. This means that headteachers have been receiving substantially less for their schools. Meanwhile, the Education Secretary has seen a 1.7% increase in block funding allocations for schools in her constituency. It is not for me to say that the Government have been prioritising the Tory shires over pupils in more urban, Labour-held seats, but the data from the House of Commons Library paints a clear picture.
The cost of food has gone up, and so has the cost of free school meals. Kevin Courtney of the NEU was right when he said:
“Teachers and support staff see the difference a healthy school dinner makes.”
When children are hungry, it is harder for them to concentrate and harder for them to reach their potential. Surely no one wishes to see or know that a child is going hungry, but it is happening and it is unacceptable. Due to this increase in cost, one school in my constituency is having to find an extra £20,000 a year out of its school budget. I anticipate that, in response, the Government will say that they have provided schools with additional funding in the last autumn statement, but from my understanding the extra funding was not for that reason. As the headteacher of a school in my constituency said:
“This will not touch the sides when we factor in our own increased energy costs, staffing costs and now having to subsidise school dinners.”
Surely the Government recognise that stretched school budgets risk lowering school standards and educational outcomes. The Government must show our country that they have a credible plan to tackle growing child poverty, to drive up standards in schools and to ensure adequate funding for free school meals. I do hope that the Government Front Benchers are listening.

Margaret Greenwood: My hon. Friend is making an excellent speech. Primary headteachers in Wirral I met before Christmas spoke about the problems facing special educational needs and disability provision in particular. They pointed out that there had been no increase in the banding for special schools since it was introduced in 2013, but that costs had increased considerably. They also mentioned that more children now need that provision and that schools were opening second sites, with associated additional costs. Does my hon. Friend agree that these children in particular should be getting the support they need, and that we really need a Government who will prioritise their needs?

Janet Daby: I absolutely agree with my hon. Friend and I am pleased that she has raised the issue of SEND children. Only this morning, one of the teachers from my child’s primary school spoke to me about the increased number of SEND children coming to her school and the increased finance that is needed from the Government. It is an area that the Government keep neglecting and they must do better, because all children from all backgrounds and with all disabilities matter.
I will go further and say that the Government need to lower their threshold to allow more children to be entitled to free school meals. These are the children who really do go hungry. I grew up as a child on a free school meals and I recognise the benefit of them. Nor is it right that children from poorer backgrounds lose out on extra school activities in school and after school because their parents or carers cannot afford them. The Government must rethink this and have a plan. Labour has a plan: we will invest the money raised by ending tax breaks for private schools to improve the education and health of every child.

Tom Hunt: It is a curious motion that has been put forward today. It is an important topic, but a curious motion. I have great respect for my hon. Friend the Member for Worcester (Mr Walker), who is now chair of the Education Committee. I was on the Committee but did not have the pleasure of serving under him; I left just before he came in, but I did support him, which might upset some colleagues on these Benches. One of the reasons I supported my hon. Friend is that he is incredibly pragmatic on education policy—I am as well—which is often what is needed. He got support across the Chamber from colleagues in all the different political parties, and I think it is wrong to say that, just because he happened to disagree with the motion, that is evidence that he is not an impartial Chairman and somehow not good at his job. I am sure he is good at his job, and I take issue with the slight attack that was launched on him earlier.
It is a curious motion, which I think is why, after the first few speeches from the Opposition Benches, their speeches have meandered off the topic in the motion and gone into broader issues to do with free school meals, etc.

Dr Caroline Johnson: My hon. Friend is making an interesting point about the curiosity of the motion. Many hon. Members have spoken about the fact that the maths do not add up. The idea does not seem to be able to raise enough money—indeed, there would potentially be a loss as a result of it—yet the money has been spent in a whole variety of ways by Opposition Members. The motion states:
“There shall be a select committee, to be called the Fair Taxation of Schools and Education Standards Committee”.
The “and Education” has puzzled me a bit. I wonder whether the Labour party will stop at taxing private schools or whether it has other forms of education in its sights, such as those who pay for maths tuition, music tuition, dance lessons or football coaching? Does my hon. Friend think that Labour has those sorts of things in its sights too?

Tom Hunt: I thank my hon. Friend for her intervention. This motion is deeply puzzling, and there are all sorts of questions like the one she has raised that have gone unanswered. We have not been helped by some of the contributions from the Opposition Benches that have increasingly strayed off the topic under discussion. Quite why the Education Committee, which is a sitting Select Committee, cannot look at this, I do not know. Why do we need to have a stand-alone Select Committee? Why would it take a year to look at this? I do not know. None of it makes any sense to me.
In terms of the impact, some of the changes proposed in the motion would lead to a number of independent schools closing, and it would not be the biggest, more established independent schools; it would be the smaller schools. There would be a consequence to this proposal. There is a legitimate debate to be had about class sizes, for example. We aspire to their being smaller, but the net result of pushing a set of policies that could lead to the closure of some independent schools would be potentially to increase class sizes, as the children who were in those schools would be in state schools. There would be a financial consequence to that.
What I take issue with is the populism and short-term politics behind this motion, which ignores the heavy lifting that is required to deal with the deeply complex issues that are rightly and understandably causing our education system to be unable to achieve its full potential.

Jonathan Gullis: Will my hon. Friend give way?

Tom Hunt: I will not give way right now.
Seeking to breed this kind of antagonism between the independent sector and the state sector is really not the right thing to do. In my Ipswich constituency, the relationship between our two principal independent schools and the state schools is close and productive. There is a huge amount of mutual learning between those two independent schools and the state schools. Trying to push the notion that, somehow, evil independent schools are behind all the ills in our state sector is regressive and unhelpful. A more constructive approach would be much more forthcoming.
I attended an independent school because I had two learning disabilities: dyspraxia and dyslexia. When I was 12, I had the reading and writing age of an eight-year-old, which most people now know because I have said it repeatedly. I could not tie my shoelaces until I was 14. I continue not to be the most organised person in the world, and I am still sometimes a bit prickly about all these sorts of things.
One reason why my father fought to put me in an independent school is that he thought I would benefit from that environment. The school helped with my learning development, not because of resources but because it had the freedom and flexibility to take an approach that works for neurodiverse individuals and unconventional learners. The reality is that a lot of young people with learning disabilities end up in the independent sector. Had I stayed in the state sector, I would have cost a lot of taxpayers’ money because of my needs, because of how far behind I was and because of some of my behavioural issues. I ended up going into the independent sector, so I was not a cost to the taxpayer. Taking policy decisions that could lead to the closure of many independent schools would  create significant new pressures, because a lot of young people with learning disabilities would go into the state sector.
Many children have my learning disabilities, and few go to the kind of school I attended, without which I would not have ended up where I am today. I am conscious of that, and I live with it every day. I campaign as hard as I can to try to make sure that every young person with the kind of disabilities I have has a fair crack of the whip to achieve their full potential. If I genuinely felt that closing down schools like the one I attended would achieve that, I would agree with this motion.
This motion does not achieve that. It is driven by politics and populism, not by what actually helps young people with learning disabilities. The Opposition are trying to make the point that, somehow, this motion would be a game changer for those with learning disabilities. Let us have a constructive debate, because we know from our casework and from our conversations with constituents that huge numbers of young people with learning disabilities are not getting the support they need, and a lot of that is because of funding. We need every teacher to have greater understanding of neurodiversity, and we need to make sure Ofsted rewards schools that are great at SEND and punishes schools that do not emphasise SEND and potentially even play the system by off-rolling students. We have to do all those things. We should have been having that debate.
I have previously spoken to my hon. Friend the Member for Worcester, the Chair of the Education Committee, about my annoyance with the funding formula and the fact that areas such as Suffolk do not get a fair deal when it comes to funding pupils per head of population. It is all in the data. The way in which money is allocated is opaque and makes no sense. Why should a young person with special educational needs in Suffolk or Ipswich get any less than a young child anywhere else? They should have exactly the same money as anyone else. All sorts of things can be done.
I am very free speaking when it comes to education policy, and I am all up for occasional constructive disagreements with the Government if what they are doing is not right for young people in Suffolk. The Under-Secretary of State for Education, my hon. Friend the Member for East Surrey (Claire Coutinho), is here, and she recently came to a special school in Ipswich.
So much of our education system is not working as it should, and many young people, including children with SEND, are being let down. I encourage a constructive debate. The Education Committee has a great platform to do that. I regretfully feel that this motion has been driven by short-term politics and not by what actually works, including for some of the most vulnerable young people in our society.

Alex Cunningham: Just under a week ago, I visited Ash Trees Academy, a primary special school in Billingham, to discuss the challenges it faces in delivering quality education to children with some of the most difficult of lives—children with both physical and learning special needs. Some of them cannot speak, and others are educated while lying down.
It was great to meet the children, but their access to the full package they need is compromised by a lack of on-site facilities and appropriate staff numbers. One  example is the lack of a hydrotherapy pool. Due to a lack of funding, the pool they had was in need of considerable improvement and the decision was taken to fill it in and to repurpose the space. Some children are now transported to another site for vital therapy and to enjoy the water, but there is not enough money in the school for them to have their own special vehicle. I visited the Dogs Trust a few weeks ago, and it has fantastic facilities, including hydrotherapy pools—for dogs!—yet this school for special-needs children does not have such facilities.
Ash Trees also has no medical person. The duties once undertaken by a school nurse, such as feeding youngsters by tube, now fall to classroom assistants. I am in awe of them for undertaking the training to do such a difficult task, but why should school assistants have to undertake that medical duty when schools in other areas have full-time medical staff on site? We owe it to the children to do so much better, and when the schools Minister visits my constituency, hopefully soon—he is nodding his head, because he has agreed to come—I hope he will be able to drop in at Ash Trees to see those challenges at first hand.
Parliament Week is always one of my favourite weeks of the year, when I can indulge myself by doing what I enjoy most, which is visiting schools. I am pleased to say that the majority of children I meet are happy in school. For some, it is the happiest place of their young lives, as they often come from a background of poverty and chaotic lifestyles.
I thought I was imagining that children in some schools are taller and have rosier cheeks and a level of confidence way beyond children in other schools, but I know it to be true. If not for breakfast clubs, free school meals and even snacks provided by teachers, many children would not be equipped to listen and learn in the classroom. It is to this Tory Government’s shame that around 40% of children in the north-east live in poverty, and their life chances are limited as a result.
Schools were in a dreadful state when Labour came to power in 1997, in terms of standards, buildings and resources. Do not get me wrong: I am pleased that recent Governments have built on the legacy left by the last Labour Administration, and I know that, in some places, many children are doing extremely well in good and outstanding schools, but we were never going to get from where we were in 1997 to where we are today in just 10 years. It had to be a long-term policy, so I am pleased that some progress has continued to be made.
Despite the best efforts of our teachers and other staff, not all children get what they need. Headteachers tell me that restricted budgets mean they cannot fill vacancies, or mean they are planning to make people redundant, and that they are worried about the children. Again, despite great strategies from our teachers, many children in key stage 1 in particular are further behind in their education due to the pandemic. Government interventions have had limited success.
As I worry about that, we are told that Eton College plans to open a sixth-form college in neighbouring Middlesbrough, backed by a right-wing Mayor who believes that troublemakers on Teesside should be removed to Rwanda. [Interruption.] The hon. Member for Stoke-on-Trent North (Jonathan Gullis) might agree, but some of those troublemakers are the product of 12 years of Tory cuts. I doubt that an elitist sixth form in our area  will help to address similar young people in our community. Had schools and children’s services been supported as they ought to have been since 2010, we might not have seen a situation where Middlesbrough’s Mayor says there are so many troublemakers that they should be robbed of their right to remain in the UK.
Is there anything like equality in education? Do we have a system that is geared to the most vulnerable and to children from difficult backgrounds? Those children do attract extra funding, but I remind Conservative Members that their successive Governments, including the coalition Government with the Liberal Democrats, have shifted more and more resources towards more affluent areas and away from areas of deprivation.

Jonathan Gullis: That’s not true.

Alex Cunningham: It is true.

Munira Wilson: Will the hon. Gentleman give way?

Alex Cunningham: I will not give way. You were complicit.
Ministers and their supporters claim it is fairer to allocate more funding per pupil, which bases funding considerably less on need. We are talking about the movement of wealth from the poor to the rich—from the areas where children are lucky to get breakfast to others where riding lessons and a host of other activities are delivered by parents who have the means to do so. I do not want those from more affluent backgrounds to lose their activities, but I do want youngsters from Tilery, Hardwick, Roseworth and Billingham to have a great local state school where they are supported to get a better chance in life. I know that can be achieved only if we invest in our children from the youngest possible age. I know from headteachers that the children who benefited from our Sure Start centres almost a generation ago were better equipped to learn when they arrived at school. If we are again to open up these early opportunities in some of our poverty-stricken estates, we will need to find funding. The Tories crashed the economy, so I support those on my Front Bench in their commitment to create funds by removing charitable status from private schools and from other pots where they can find that money.
I know there are parents who make sacrifices to send their children to private schools—we have heard examples of this from Conservative Members—and I admire them for it, but that is their choice. It does not mean that schools should be subsidised by the taxpayer when some state schools are shrinking or closing because they have insufficient numbers. So let us refocus our approach to funding education in this country; let us recognise that we need to fund on the basis of needs instead of numbers; let us deliver the support for our children with special needs, such as those I met at Ash Trees; and let us deliver the opportunity to allow every child to reach and even exceed their potential.

Toby Perkins: On a point of order, Madam Deputy Speaker. [Interruption.] Don’t look so disappointed. We are having a debate on fair taxation of schools and the argument has been made many times by Conservative Members that in the event of fair taxation of schools the amount being paid by parents of pupils at independent schools would go up. On that basis, it seems to me that anyone who educates  their children in the independent sector has a personal interest, and I wonder whether they should be declaring that interest before speaking in this debate.

Rosie Winterton: I thank the hon. Gentleman for that point of order, but  I feel that it is really not the right approach to interrupt a debate with a point of order from the Front Bench. If a point needed to be made, the Opposition spokesperson could make it or it could be made after the debate. The hon. Gentleman has not been here for the whole debate. I want to get on with the debate, which is only right, because many people have sat here throughout the whole debate, especially the colleague I am going to call next. So I think we will just move on. I call David Johnston.

David Johnston: Thank you very much, Madam Deputy Speaker. First things first, let me say that I went to the comprehensive school at the end of my road, which had a 21% GCSE pass rate in the years I was there. That was before the inclusion of English and maths, and had they been included, it would probably have been a school with a single-digit pass rate. I do not have any children so I am not sending any children to a private school.
I think we obsess too much about private schools in this country. They provide an excellent standard of education and that appeals to parents in not just this country, but internationally. I think some of these schools do lots to justify their charitable status whereas others do not do enough and should be doing more. I think that our leading professions should not contain a huge proportion of people who are privately educated, given that such schools educate only 7% of the country. But that is as much about those professions as it is about the schools.
So I do not stand here as a great advocate or champion of private schools, but I know that the people who have engaged in this debate have made a strong case that this policy from the Labour party would not save any money to be distributed elsewhere—it might even cost the state more than it is being charged at the moment. Sir Peter Lampl, from the social mobility charity the Sutton Trust, has said that if we want to increase the inequities inherent in the public school system, we could not devise many quicker ways of doing it than this. Many people have commented on the complications it might provide for other areas of education that are also not being charged these taxes.
I also know why the Labour party is doing this. It is doing it because it fires up Labour Members, although it does not fire them up as much as I thought given the empty Benches opposite. They think it is a way of also getting at the Prime Minister, the leader of our party. That is curious, because when we go through the history of the Labour party, we see that only three Labour leaders have won an election in the post-war period and two of them were the products of boarding schools. When we go through the key figures in the Labour party, over and again we find that they were privately educated. I am thinking of people such as Gaitskell and Foot, and the Leader of the Opposition went to a  school that became a private school. So although private schools have not played any role in my life, where would the Labour party have been without the alumni of our private schools? Labour would have won even fewer elections.
We talk about this policy, but my main problem with it arises not because I am a great defender of private schools, not because it will not save us that much money, and not because it might make the problem worse or make the Labour party’s electoral history worse. My problem with this policy is that we have waited three years for education policy from the Labour party and this is what it has come up with. If we want to talk about records and 13 years of Conservative government, I will gladly stand by this party’s record on education in those 13 years. I know that the Minister of State, Department for Education, my right hon. Friend the Member for Bognor Regis and Littlehampton (Nick Gibb) is going to set it out in great detail when he sums up.
If we want to talk about records, let us talk about the Labour party’s record on education in the past three years. The Labour party wants us to forget that everyone elected on that side of the House stood on a manifesto to abolish standard assessment tests, academies and Ofsted, all of which have done a huge amount for disadvantaged children in this country. Labour Members want us to forget that when schools closed and their allies in the National Education Union said that teachers should not teach a full timetable or routinely mark work in this period, the Labour party said nothing about that. It said nothing about that when it produced a 200-point checklist for schools to reopen. Labour Members want us to forget how long it took them to say that schools are safe. Does everybody remember that? Every Front-Bench spokesperson used to say, “Come on, Leader of the Opposition, come on shadow spokespeople, say that schools are safe and that children can go back to them.” It took them so long to do so. We wait three years for policy and this is all that the Labour party can come up with. I did not believe that this was the only policy, so I went to the party’s website, because I thought that other education policies must be on there, but the website is bare. The only thing remotely relating to education is about breakfast clubs in primary schools. I support breakfast clubs in primary schools; the schools I was a governor of had them and they are very effective, but that is not a big enough policy for the whole of our education system. We have undertaken big reforms in this period and we have still face big challenges, some of which are decades old and some of them post covid. We need more than this, so I thought I would look at the Leader of the Opposition’s speech from last week. Both he and the Prime Minister set out what they wanted for the country in their speeches last week. The Prime Minister referred to education 12 times in his speech last week. Tony Blair used to say, “Education, education, education”. I counted up the number of times the Leader of the Opposition said “education” in his speech last week setting out for the country what he wanted to do. Guess how many times it appeared? The answer is: zero; it did not appear once. Not once in a speech telling the country what his priorities are and what he is going to do for the country does the word “education” appear. And zero is precisely what the Labour party has to offer the country on education.

Rosie Winterton: I call the shadow Minister.

Stephen Morgan: It is a pleasure to have the opportunity to conclude this debate in support of the motion in my name and the names of the shadow Education Secretary and the Leader of the Opposition.
I wish to start by saying thank you—thank you to teachers, school support staff, school leadership teams and everyone who works in schools across the country. Their job can often be a thankless one, but it has been particularly difficult in recent years. The work that they do could not be more important and I hope that they know that they have our respect, our admiration and our support.
My hon. Friends the Members for Lancaster and Fleetwood (Cat Smith), for West Ham (Ms Brown), for Liverpool, West Derby (Ian Byrne), for Kingston upon Hull West and Hessle (Emma Hardy), for Lewisham East (Janet Daby) and for Stockton North (Alex Cunningham) have articulated the importance of this debate in raising educational standards for children in England’s state schools.
My hon. Friend the Member for Lancaster and Fleetwood made powerful points about the value of quality teaching and the significant challenges of recruitment and retention and morale of the workforce. I know that she is a tireless champion for schools in her constituency and I thank her for her contributions today. My hon. Friend the Member for West Ham spoke with her usual passion and energy about the challenges that schools in her constituency are facing and the 12 years of failure by the Tories to tackle these issues head on.
My hon. Friend the Member for Liverpool, West Derby made helpful points about his continued efforts on food poverty and the political choices that the Government could make to transform children’s lives. My hon. Friend the Member for Kingston upon Hull West and Hessle robustly challenged those on the Government Benches on the views that they have expressed today, and I thank her for her consistent work on raising issues around oracy in this House. My hon. Friend the Member for Lewisham East helpfully shared issues in her area with regards to school funding and concerns about the impact that is having on the education of children in her local community.
Members of the Conservative party may be trying to airbrush their former leader out of history, but they cannot airbrush their record in Government. Over the past decade, the Conservatives have turned back the clock on education, with attainment gaps widening, teacher pay falling, SEND education broken, school buildings crumbling, and teacher recruitment and retention in crisis. This situation is not fair, it is not sustainable, and Labour will not stand for it. We believe that excellence is for everyone. Labour wants to raise educational standards across the country. We want to pay for teachers, pay for mental health support and pay for careers guidance to drive higher standards for the majority of children in all our state schools, The tax breaks that private schools enjoy must end. That is why we are asking all Members to support that ambition by establishing  a time-limited, focused new Select Committee, to report by July this year, to look into how we end these tax breaks and invest that money in our nation’s schools.
Every parent wants the best for their children. We will not criticise any parent for the judgments that they make on how to do that—not now, not ever. But Labour wants to deliver the best for every child, in every school, in every corner of our country. This is simply about children’s outcomes: recruiting more excellent teachers to improve those outcomes; improving the mental health of our children to improve those outcomes; and revitalising careers guidance to improve those outcomes. While those on the Conservative Benches were busy last year each taking a turn at being the Secretary of State for Education, the Labour party was busy building a vision for the future of education. That means funding it fairly and properly.
Labour has set out how we will do that. We will use the money that is raised to drive up standards in every state school. We will do that: through a national excellence programme, recruiting thousands of new teachers; providing professional mental health support for every child; and ensuring young people leave education ready for work and ready for life, with professional careers guidance and work experience for all. As the shadow Education Secretary said earlier, this is what aspiration for our children looks like.

Simon Hoare: It all sounds absolutely fantastic, but the shadow Minister is hiding his light under a bushel. If that is not on his Labour party website and if his Leader has not mentioned education at all in his new year launch speech, how are we supposed to know about these things—telepathy?

Stephen Morgan: I would expect better of the hon. Member, but I am delighted that he is already looking at the Labour party website. I can send him the membership links so that he can join the party, too.

Jonathan Gullis: rose—

Stephen Morgan: I will make some progress.
Education is about opportunity—opportunities to learn and grow, to achieve and flourish, and to have happy and healthy childhoods. Governing is about priorities, and VAT giveaways to private schools show exactly where the Conservatives’ priorities lie. They lie not in helping every child to get a great state education, but in helping the wealthiest in society. A Labour Government would make fairer choices. They would do so by asking those with the broadest shoulders to pay their fair share.

Jonathan Gullis: I am incredibly grateful to the shadow Minister, who is a good man. He pointed out that some of the money raised would go into teacher recruitment. What specifically will Labour use that money on to drive up teacher recruitment? Will it be by carrying on the bursary scheme and adding more money to it—I signed off on the £28,000—or is there another system that I am not aware of that Labour thinks will work? What specifically will Labour do on recruiting teachers with this extra money?

Stephen Morgan: I am very happy to send the hon. Member the document, or I will gladly meet up with him when I am campaigning in his constituency next week to make sure that he is not returned at the next election.
As I was saying, Labour would require private schools to pay business rates, as state schools already do, and to pay VAT, as our colleges already do. In these extremely difficult times, with energy bills going up and pay going down, to ask the public to subsidise a tax break for private schools is inexcusable, and we are not talking about small sums.
Yesterday’s report by openDemocracy demonstrated further where the Government’s priorities lie. It found that private schools were handed more than £157 million in Government-subsidised loans during the pandemic, under a scheme that barred state schools from applying. This included elite institutions such Charterhouse, where the Chancellor went to school, which received a £5 million loan, despite declaring £45 million of income that year.
Those on the Conservative Benches, and even the Chancellor, have recently quoted figures from the Independent Schools Council saying that Labour’s policy will cause private schools to shut, and that thousands of pupils will leave the private sector. However, the Institute for Fiscal Studies found that those claims do not stack up. Although fees have risen significantly in the past 20 years, the proportion of pupils in private education has hardly changed.
The Education Secretary claimed earlier that the figures she cited did not come from the private school lobby, so can she be more specific? Did they come from the Treasury? If they did not, why do the Government not ask their own officials to look into this? Unfortunately, I think we all know why. It is because the Government would not like the answers they would get.
The Government’s position is not only wrong but unpopular. Recent polling shows that Labour’s plan has the country’s overwhelming support. The public are right to ask why private schools get tax breaks when state schools face impossible choices on what resources or staff members to cut, and it is not just voters who support Labour’s plans. As we have heard, many Government Members do too, even if they do not want to admit it. Let me share some quotes. In 2017, the current Minister of State, Department for Education, the right hon. Member for Harlow (Robert Halfon) said:
“It is not clear why private schools, many of whose costs to parents are literally in the stratosphere, should be regarded as charities. To what purpose?”
The current Secretary of State for Levelling Up, Housing and Communities said:
“Private school fees are VAT-exempt. That tax advantage allows the wealthiest in this country, indeed the very wealthiest in the globe, to buy a prestige service that secures their children a permanent positional edge in society at an effective 20 per cent discount. How can this be justified?”
I wonder whether those right hon. Members will follow through on those words and back Labour’s motion in the Division Lobby today.
In conclusion, after 13 years of Conservative economic mismanagement, which culminated in those on the Conservative Benches crashing the economy last year, tough choices must be made to protect the public finances.  But the choice facing MPs today is easy. They can choose to spend £1.7 billion on tax breaks for private schools—not our figures, but those of the respected Resolution Foundation—or they can choose to spend it on teachers, mental health support for pupils and revitalising careers advice, so that our young people can receive that support across the country. I challenge the Minister and Conservative Back Benchers to vote for the motion today to ensure that every child in every corner of the country receives a brilliant state education, because excellence should be for everyone.

Nick Gibb: To be frank, this debate has not been a triumph for the Opposition Front Bench. As my hon. Friend the Member for Meon Valley (Mrs Drummond) pointed out, no Labour MP actually spoke in favour of, or even mentioned, Labour’s motion today.
I think it is fair to say that every Member of the House wants to see high academic standards in our schools and to make sure that every child reaches their full potential. What divides us is how to achieve that, as my hon. Friend the Member for Wantage (David Johnston) powerfully exposed in his brilliant speech.
On the Government side, we believe that promoting an evidence-based approach to the teaching of reading and arithmetic in primary schools is key, and that empowering teachers to maintain good and improving pupil behaviour is essential if children are to be able to concentrate and work in a safe and calm environment. We believe that, notwithstanding the existence of Google, the curriculum should be rich in knowledge and give young people the cultural capital and cognitive skills to navigate and succeed in a modern society and economy.

Emma Hardy: I thank the Minister for giving way; he is always generous. On the issue of quality and knowledge-based teaching, will he respond to my point that the Education Endowment Foundation found that teaching explicit oracy skills in schools increased children’s progress by more than six months for pupils from the most disadvantaged backgrounds? Is that evidence being considered by his Department?

Nick Gibb: I agree with the hon. Lady on the importance of debating, speaking and discussing issues in class. That is terribly important.
We introduced the phonics screening check in 2012, ensuring that every six-year-old is on track with their reading. In 2012, just 58% achieved the expected standard; by 2019, just before the pandemic, that figure had reached 82%. We have risen from joint 10th to joint eighth in the PIRLS—progress in international reading literacy study—survey of the reading ability of nine-year-olds, scoring our highest ever results. That success is attributed to the focus on phonics and has been driven by improvements among the least able pupils.
We changed the primary school national curriculum, improving rigour in English and driving the habit of reading for pleasure, and adopting an approach to mathematics based on the highly regarded Singapore maths curriculum. That came into force in 2014 and the new, more demanding SATs at the end of primary school, based on that new curriculum, came in in 2016.  Between 2016 and 2019, before the pandemic, the proportion of 11-year-olds reaching the expected standard in maths rose from 70% to 79%, and in the TIMSS—trends in international mathematics and science study—survey of the maths ability of pupils around the world, our year 5 pupils significantly improved between 2015 and 2019.
We introduced a multiplication tables check, ensuring that every nine-year-old knows their times tables. This June, 27% achieved full marks in the test and the overall average score was 20 correct answers out of 25. The approach of the Government over the last 12 years has been about standards—raising standards in our schools. That is why the proportion of schools graded good or outstanding has risen from 68% in 2010 to 88% now.
We reformed the GCSE qualifications to make sure that we are on a par with the best-performing countries in the world. We removed the controlled assessments from most GCSEs, as Ofqual said they were less reliable than written examinations. Our reformed GCSEs are now the gold standard, the curriculum is more knowledge-rich and the assessment process is fairer and more rigorous.
When I read Labour’s key education policy document—not on the website, but report of the council of skills advisers, chaired by Lord Blunkett—I cannot see the same commitment to standards. One of Labour’s key recommendations is:
“Introducing multimodal assessments so that young people’s progress is no longer measured solely through written exams.”
Exams are key to maintaining standards and in ensuring that our qualifications are rigorous and fair. David Blunkett’s report was endorsed by the Leader of the Opposition. Will the hon. Member for Houghton and Sunderland South (Bridget Phillipson) take this opportunity to disown from the Front Bench that pledge in that document?
Exams are fundamental to maintaining standards and ensuring that our qualifications are rigorous and fairly awarded. Why is Labour so committed to abolishing exams? What is its policy on reading and phonics, and the phonics screening checks? Is that another test they want to replace with a multimodal assessment? What about key stage 2 SATs or the multiplication tables check? What about GCSEs and A-levels, and all the important markers of standards and checks of pupil progress? Are they all to be replaced by Labour’s multimodal assessment?
My hon. Friend the Member for Worcester (Mr Walker), the Chair of the Select Committee, made the important point that charitable status for education has been in place for over a century and that every Labour Government in that period supported that charitable status. He pointed out that Labour policy would make independent education more elite and more expensive, confined to the very rich and to overseas pupils. He also asked the key question of whether the £1.7 billion Labour claimed the policy would yield excluded the VAT that Labour has conceded will not be applied under this policy to the independent special schools catering for children with complex needs.
My hon. Friend the Member for Stoke-on-Trent North (Jonathan Gullis) made the point that the maths of the proposed policies does not add up, with no account taken of potential independent school closures. In a powerful contribution, he cited a statistic not mentioned  so far: that before the pandemic, the attainment gap had closed by 13% in primary schools and 9% in secondary schools.

Alex Cunningham: rose—

Nick Gibb: I will not give way now, I am afraid; there is no time left.
My hon. Friend the Member for Bassetlaw (Brendan Clarke-Smith) gave the debate the key quote that
“education is a necessity, not a luxury”.
He is right, and he was right when he said that Labour’s policy in the motion was simply about the politics of envy.
My hon. Friend the Member for North Dorset (Simon Hoare) was right to describe Labour’s education policy as divisive. My hon. Friend the Member for Ipswich (Tom Hunt), in a moving speech, challenged Labour’s motion for breeding
“antagonism between the independent sector and the state sector”,
which is unhelpful and does not help young people with learning difficulties.
Independent schools have long played a part in this country’s education system, allowing parents to choose the education that is right for their child. The majority of the sector is made up of small schools, including those providing education to religious communities or catering for special educational needs, and the latter provide much-needed special school and alternative provision places, which are state funded. The Government believe the state education sector can and does benefit from collaboration with the private sector.
The hon. Member for West Ham (Ms Brown) spoke about the London Borough of Newham, which is one of the poorest boroughs in the country, but thanks to this Government and the work of the former mayor of Newham, Sir Robin Wales, Newham is now one of the highest-performing education authorities in the phonics screening check and regularly appears in the top 10 local authorities for key stage 2 results in reading, writing and maths. She failed to mention Brampton Manor Academy in Newham, which last year sent 85 of its pupils to Oxbridge and 470 to Russell Group universities.

Lyn Brown: Will the Minister give way?

Nick Gibb: I will not give way—there is no time left, I am afraid.
The hon. Member for Twickenham (Munira Wilson) cited the partnership that Reach Academy Feltham has with two prominent local private schools. That is, of course, one of 7,000 such partnerships with 936 primary schools.[Official Report, 19 January 2023, Vol. 726, c. 6MC.]
The Government are committed to raising standards in our schools, and we have succeeded in raising standards in our schools, although there is more to do.

Lyn Brown: Will the Minister give way?

Nick Gibb: I will not give way.
The Government are committed to education as the key to every individual’s ambition. We want every child to fulfil their potential. This Government—despite all the competing pressures and the fiscal and public finance  challenges facing this country—allocated in the autumn statement an extra £2 billion of funding for schools next year and the year after, in addition to the extra funding allocated for those two years in the 2021 spending review. With this year’s £4 billion increase and next year’s £3.5 billion increase in school funding, that is a 15% rise in just two years. By 2024-25, school funding will be at its highest ever level in real terms as well as in cash terms.
That is the focus of the Government. The Opposition may focus on private schools and on constitutional reform, but our determination is to make every local school a good school. We are concentrating on ensuring that all pupils catch up after the challenges caused by the pandemic, which is why we are spending £5 billion on tutoring and other support for pupils to help them catch up.
The Government are committed to continuing to drive and raise academic standards and standards of behaviour in our schools. That is what parents want, it is what pupils want, and it is what our economy needs. I urge the House to reject Labour’s divisive motion and, by doing so, to endorse the Government’s approach to delivering a high-quality education for all our children.
Question put.

The House divided: Ayes 197, Noes 303.
Question accordingly negatived.

NHS: Long-term Strategy

Rosie Winterton: I inform the House that amendment (a), tabled in the name of the Prime Minister, has been selected.

Wes Streeting: I beg to move,
That this House condemns the Government for failing to recognise the current crisis in the National Health Service; regrets that, as a result of Government mismanagement, hundreds of lives may be being lost every week due to the collapse of emergency care while patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Prime Minister to acknowledge the crisis and act with the necessary urgency to mitigate the impact on patients; and further calls on the Secretary of State for Health and Social Care to ensure the NHS is never in this situation again by bringing forward a long-term strategy which will end delayed hospital discharges, provide the NHS with the necessary staff to treat every patient in good time, and reform primary and community care to reduce the number of people needing hospital treatment.
I rise to support the national health service, which is going through the biggest crisis in its history, and most importantly, to defend the patients who are suffering as a direct result of 13 years of Conservative mismanagement of the NHS. This winter has shown just how high a price patients are paying: NHS staff are walking out on strike—in the case of nurses, for the first time in their history—patients are waiting entire days for an ambulance to arrive, and then days on end in A&E before they are admitted; there were 50,000 needless, preventable deaths last year, which experts have blamed on unacceptably long waiting times; and there have been hundreds of avoidable deaths every week this winter, because emergency care has collapsed.
The Secretary of State for Health and Social Care says that he disputes those figures from the Royal College of Emergency Medicine and the Office for National Statistics, but I invite him to listen to some of the stories behind the numbers. An 89-year-old fell in the bathroom and waited nine hours for an ambulance. The sepsis that caused him to fall killed him. His consultant said:
“Had I seen him within a couple of hours it could have been avoided. Maybe.”
Teresa Simpson, a 54-year-old woman from Hull, suffered a cardiac arrest and lost oxygen supply to the brain. She waited 16 hours for an ambulance, which arrived only when her husband phoned 999 a second time, after she had become lifeless. She passed away. A consultant in the north of England described a scene in a hospital waiting room this winter when a patient collapsed:
“They get CPR on the floor. I am forced to declare his time of death in front of frightened, horrified members of the public and his wife. On the floor of the waiting room. He was elderly and frail and hadn’t wanted to bother us. We had run out of trolleys and beds. In the whole hospital. This was by 10am.”
The Prime Minister refuses to describe this as a crisis.
Our motion before the House calls for a long-term plan to end delayed discharges, give the NHS the staff it needs to treat patients on time, and reform primary and community care, so that fewer people end up in hospital.

Alun Cairns: Will the hon. Member give way?

Wes Streeting: The Government do not have a plan, but perhaps the right hon. Gentleman will surprise me by telling me, against all hope and expectation, that they do.

Alun Cairns: Clearly, some of the statistics and cases that the hon. Member highlights are distressing and no doubt need to be investigated. The Prime Minister has rightly prioritised waiting times as one of his key commitments this year. How does the hon. Member account for the performance in Wales, which is worse than in England on all the statistics that we highlight, in spite of the Labour party having been in charge of the NHS there for more than 20 years?

Wes Streeting: I am grateful for the right hon. Gentleman’s intervention, because it brings me directly to the Government’s amendment to the motion, which is not a plan but a litany of excuses for the situation across the United Kingdom, including in Wales. I will run through them. By way of excuse, they say that the situation is challenging across the United Kingdom, and they are right: in Wales, the NHS is struggling; in Scotland, the NHS is struggling; and in Northern Ireland, the NHS is struggling. What do all parts of the United Kingdom have in common? Thirteen years of Conservative underfunding.
I will tell the right hon. Gentleman that, as he knows perfectly well as a Welsh Member, the reason why the Welsh NHS struggles more than England overall is the age profile of the population, the number of disabled people in Wales and the level of deprivation. The same disparities between Wales and England overall also explain the enormous health inequalities within England, which is why health outcomes in my city—in London—are so much better than in so many parts of the north or south-west of England. And you know the way to deal with that? It is genuine levelling up. But if people want a Government who tackle health inequalities so that every person in every part of the United Kingdom gets good-quality healthcare, they need to elect a Labour Government here in Westminster. That is the truth that the right hon. Gentleman does not want to admit.
I know that SNP Members will not be here today, because we are talking about England, but here is another truth that Nicola Sturgeon does not want to admit either: people in Scotland will be better off under a Labour Government too. She knows that just as well as anyone else.
When Conservative Members are not talking about other parts of the United Kingdom, they say that health pressures exist right across the world, but international pressures do not explain why the average wait for an ambulance is 14 minutes in France, while heart attack victims and stroke victims routinely wait an hour for an ambulance here in England. International pressures do not explain why it is that, over the past year, one in six UK adults had a pressing need for medical examination or treatment but could not get access. They do not explain why this is the highest figure out of 36 European countries and almost triple the EU average. Their excuses about international pressures do not explain why cancer outcomes in England are behind other comparable countries. None of that explains why the state of the NHS is as bad as it is today, but perhaps the hon. Member for Bosworth (Dr Evans), who was trying to intervene, wants to stand up and justify why it  is that, after 13 years of Conservative Government, his constituents are waiting an average of an hour for a heart attack or stroke case.

Luke Evans: I am grateful to the hon. Member for giving way, and there are two points that I would like to pick up, seeing as he has come back to me on the second one. The first one, about comparable data, is really important. Does Labour have a position on sharing data between Wales, for example, and England, because the data is not comparable, which makes it very difficult to work out what is going on? Secondly, a plan was brought forward by the Government. It is called the NHS White Paper, which was brought forward by the NHS to transform the NHS with the integrated care boards, which are now in place. The people on those boards—42 of them—are the best people to make that change.

Wes Streeting: I find it astonishing. The hon. Gentleman’s position seems to be this: the Government have a plan, after 13 years, and apparently that plan is in progress. So why is it that so many Conservative Members just this week have stood up to talk about the fact that their constituents cannot see a GP, they cannot get an ambulance when they dial 999, and they are waiting hours on end in A&E departments? I know they like three-word slogans, but is the latest Conservative slogan on the NHS really “Crisis, what crisis?”?

Lee Anderson: I have received several emails from Labour party members in Ashfield asking me to back the Labour party’s fully costed NHS plan. Could the hon. Member please send me a copy?

Wes Streeting: I would be delighted. I can barely believe it. Honestly, I can barely believe it. This is the second time this week that Conservative MPs have said, “We need to see Labour’s plan, because we haven’t got one.” I would be absolutely delighted. The hon. Member can even sign it and put it in one of his party’s fundraisers—God knows he is going to need it at the next general election. I will tell him what the plan is: it is a fully funded, fully costed plan to deliver the biggest expansion of NHS staff in history—doubling the number of medical school places; 10,000 more nursing and midwifery clinical training places; 5,000 more health visitors; and doubling the number of district nurses. That is my plan. Where is their plan?
The Government amendment refers to funding and states that they are putting in an extra £14.1 billion. I wonder how much of that will be swallowed up by the inflation caused by their catastrophic mismanagement of the economy. People are not just paying the Truss and Kwarteng premium; this is the price of 13 years of low growth, low productivity, high taxes and stagnation. Every penny will be swallowed up by higher inflation. That is the truth. Why do people talk about 13 years of underfunding? It is because they know it did not need to be like this, and because they saw what the last Labour Government did. With Labour, per capita spending on health increased by 5% each year, and we were able to do that because we grew the economy. Under the Conservatives, spending per capita fell during the coalition years, fell in the following two Parliaments, and even the increases that the Government promise today will not match the investment that Labour put in. That is the price of Tory economic failure.

Seema Malhotra: My hon. Friend is making an outstanding opening speech. My constituent told me last week about his relative who has multiple myeloma and had a stem cell transplant last year. She had a bad viral infection for three weeks, which is a serious issue after chemotherapy and a transplant. My constituent was asked by her consultant to take his relative to another hospital, because no beds were available at the hospital where she was being treated. She was treated in the corridor and waited 24 hours for a bed. Does my hon. Friend agree with my constituent that that hospital and its staff were not to blame and that, with underfunding and no strategy for the NHS now or in the future, the fault lies squarely with this Government?

Wes Streeting: I wholeheartedly agree. We hear this time and again. When patients are struggling to get access, and experiencing appalling delays in accident and emergency, they do not blame the staff. They know that the staff of the NHS are busting a gut, but those staff are suffering in the same way as patients because of 13 years of Conservative mismanagement. The only part of the Government’s amendment that I agree with is the part that praises NHS staff. Why is the Secretary of State’s Prime Minister bringing in his “sack the nurses” Bill next week? How many nurses will he sack? How many paramedics or junior doctors will he sack? The only people who need the sack are this Government—[Interruption.] Perhaps the hon. Member for East Worthing and Shoreham (Tim Loughton) agrees.

Tim Loughton: When the last Labour Government left power, they were spending 8% of GDP on the NHS. Last year that figure was 10.6%, which is average for the EU nations. Why did the last Labour Government so chronically underfund the NHS?

Wes Streeting: The hon. Gentleman has got some brass neck. I have already given him figures showing that per capita funding increased by 5% under the last Labour Government—[Interruption.] And as for GDP, perhaps he should look at growth figures and ask why the economy is so much smaller than it would have been if we had had a Labour Government managing the economy well. That is the truth; it is a simple fact. If not, perhaps he wants to explain how his Government will put more money into the NHS, but I did not hear that commitment.

Toby Perkins: I thank my hon. Friend for his excellent speech. I do not quite know why I have intervened, because I am very much enjoying watching him flay the bowling to the boundary when he gets questions from Conservative Members. He is absolutely on to something in relation to the money that has been wasted in our NHS by the failure to plan for NHS staffing. Is not the reality that far too much money is being spent on agency workers because there is no long-term strategic plan for NHS staffing?

Wes Streeting: My hon. Friend is absolutely right. We are spending £3 billion on agency costs that would surely be better spent on ensuring that we have a serious workforce plan, and on hospital departments that are staffed by regulars who get to know their shift, get to know their colleagues, and get to know their patients and communities.
Let me turn to what the Secretary of State for Department for Business, Energy and Industrial Strategy said about ambulance staff, because I think he irresponsibly suggested that ambulance staff have not committed to minimum service levels for category 2 calls today, which is just not true. I think he ought to apologise to ambulance workers.

Luke Evans: rose—

Angela Eagle: rose—

Wes Streeting: I will give way to my hon. Friend the Member for Wallasey (Dame Angela Eagle), who has been waiting.

Angela Eagle: On minimum service guarantees, does my hon. Friend think that the Conservative party has a brass neck to try to enforce minimum service guarantees, which are always made by agreement on any strike anyway, but says nothing at all about the catastrophic loss of service guarantees because of their mismanagement and underfunding on every other day?

Wes Streeting: My hon. Friend brings me neatly to the argument that I want to make about minimum service levels. Let me tell the Health Secretary who they are talking about when the Government attack ambulance crews. Donna Wilkins called an ambulance when she became concerned that her disabled son James may have been having a stroke, which is a listed side-effect of the medication that he takes. She and James waited in an ambulance for nine hours outside the Royal Bournemouth Hospital because there were no beds. Paramedics waited with them for the full nine hours. They chatted with James, loaded his favourite TV shows on their phone for him to watch and ran into the hospital to bring tea for Donna and soft food for James, who has problems with swallowing, which they spoon fed him. This is who NHS staff are. This is who ambulance crews are. These are the very staff the Government would have sacked with the legislation that they are bringing forward next week. As my hon. Friend said, what brass neck from this Government to talk about minimum standards on strike days when they cannot deliver basic minimum standards on any other day of the year.
The two-month target from GP referral to cancer treatment has not been met since 2015. Four in 10 people are waiting more than four hours in A&E. The four-hour target for A&E waits has not been met since 2015. The 18-week treatment target for elective care has not been met since 2016. One in seven people cannot get a GP appointment when they try. More than 1.3 million waited more than a month to get a GP appointment in November. How much more evidence do the Government want that they are incapable of delivering the minimum basic standards that patients deserve every single day of the year?
This has to be seen to be believed: the Government are planning an advertising campaign to urge patients to stay away from the NHS with the tagline “Help us help you.” Do they not see the risk in patients not coming forward for help when they need it? Can they not understand that people are fed up with being told that they have to protect the NHS, rather than the other way round? Instead of asking the public to help the NHS, the public want the Government to help the NHS to help them.

Andy McDonald: I do not know whether my hon. Friend is as horrified as I am by the juvenile and facile comments from the Conservative Benches, or whether he heard today on Radio 4 about the 600,000 people who every single month are waiting for four hours or more to get into A&E and be treated. As a direct result, horrifyingly, each and every month, hundreds and hundreds of people are dying needlessly in our country. That is on this Government’s watch. Should they not be hanging their heads in shame?

Wes Streeting: I wholeheartedly agree with my hon. Friend—avoidable and preventable. The Chancellor wrote an entire book about getting the number of preventable deaths down to zero, because that is where the figure should be, so to have 50,000 preventable, avoidable deaths reported is a badge of shame for the Government.
Worst of all, the height of the Prime Minister’s ambition is to stop making things worse. If we have 7.1 million people waiting for treatment, rather than 7.2 million people, apparently that is a job well done in the Prime Minister’s book. Our NHS needs to be rebuilt and renewed, but all he offers is managed decline. His five pledges have the bar set so low that even his predecessor could meet those promises.
If hon. Members want to know what real ambition and action look like, it is this: 89,000 more nurses; 44,000 more doctors; waiting times cut from 18 months to 18 weeks; 3 million more operations carried out each year; banning smoking in pubs; the largest hospital building programme in history promised and delivered; 100 new walk-in centres; GP appointments guaranteed within two days; free prescriptions for cancer patients; appointments with a cancer specialist within two weeks of referral; waiting lists cut to their lowest point in history; and patient satisfaction at its highest levels in history. That is the difference that a Labour Government make.

Natalie Elphicke: On delivery by Labour, over the many years of a Labour Government, Dover and Deal saw its health service absolutely decimated, service by service. What has happened under a Conservative Government? There has been a new hospital built for Dover, the first dementia village in the country, built for Dover and Deal, one of the first 40 diagnostic covid hubs, delivered for Dover and Deal, and a new GP training centre, delivered for east Kent. Of course, there is more to do on health, but we have the plan—

Nigel Evans: Order. Interventions must be brief by definition.

Wes Streeting: I cannot believe that the Member for Dover and Deal seems to be standing up and telling her constituents that when it comes to the NHS they have never had it so good. I know she is desperate and scraping the barrel because Prime Minister after Prime Minister have broken their promises on immigration and the Prime Minister is not dealing with small boat crossings, but I am afraid that pretending the NHS is working will not save her at the next general election.
To govern is to choose and the last Labour Government showed that investment plus reform equals better standards for patients. You do not need to do A-level maths to get to that equation. The right hon. Member for Gainsborough (Sir Edward Leigh) asked his Health Secretary:
“What is our long-term plan? We cannot leave the Labour party to have a long-term plan while we do not. How are we going to reform this centrally controlled construct?...What is the Secretary of State’s plan?”—[Official Report, 9 January 2023; Vol. 725, c. 297.]
What indeed is the Secretary of State’s plan? He has been in power for 13 years. His Government have presided over this record and still, after 13 years, they have no plan. Conservative Members asked what my plan was and I outlined it: a fully costed, fully funded plan to deliver the biggest expansion of NHS staffing—[Interruption.] They are saying, “Where is it?” I will repeat it for them again: double the number of medical school places; 10,000 more nursing and midwifery clinical training places; 5,000 more health visitors; and doubling the number of district nurses qualifying, paid for by abolishing non-dom tax status, because we believe that people who make Britain their home should pay their taxes here, too.
I understand that, in their partisan fury, because they cannot bear the fact that Labour has a plan and they do not, Conservative Members cannot swallow humble pie enough to take our plan and run with it. If they do not believe me, they should at least believe their own Chancellor, because this is what he said about Labour’s plan:
“I very much hope the government adopts this on the basis that smart governments always nick the best ideas of their opponents.”
If we were in any doubt already, this is not a smart Government and it will take a Labour Government to deliver Labour’s plan. That is why we end up with these sticking plasters, as we saw on Monday, to deal with this crisis.
Why did the Government choose to leave 230,000 patients languishing on NHS waiting lists when the spare capacity was there for them to be treated in the private sector? We know what our priority is: get patients treated as quickly as possible, pull every lever available to make it happen and make sure that patients do not have to pay a penny. The Government could act on doctors’ pensions to stop doctors retiring early for no reason other than that there is a financial disincentive to stay, but they still have not done it. They could bring strikes to an end by negotiating with the unions instead of threatening to sack the staff, but they still have not done it.

Tim Farron: I want to give the hon. Member an idea to nick. He mentioned earlier the chronic situation with cancer waiting times, with 40%-plus of people diagnosed with cancer waiting two months to be seen. I wonder if he is aware of the work of the all-party parliamentary group on radiotherapy; I chair the group and his hon. Friend, the hon. Member for Easington (Grahame Morris), is a vice-chair. Fifty per cent. of people with cancer need radiotherapy. We spend 5% of the cancer budget on it. The average across developed nations is about 9%. Will he agree to give a bit of time to come to the group’s inquiry on 18 January? In looking at Labour’s plan, will he consider how we can fund radiotherapy, so we can treat people and do not have so many avoidable deaths?

Wes Streeting: Unlike the Government, we are happy to look at good ideas wherever they come from. I do not know whether I can make 18 January, but I am certainly happy to meet the hon. Gentleman so that we can ensure that Labour’s plan tackles the appalling waits that we are seeing for cancer treatment.

Vicky Ford: Will the hon. Gentleman give way?

Wes Streeting: I have to make progress. I know that Conservative MPs were not interested in speaking in this debate, but many Labour Members were.
We cannot continue pouring money into 20th-century healthcare that is not fit for the future. We do not focus nearly enough on prevention, early intervention and care in the community. Because people cannot see a GP, they end up in A&E, which is worse for them and more expensive for the taxpayer. Because people cannot get the mental health support they need, they reach a crisis point, which is worse for them and more expensive for the taxpayer. Because people cannot get the social care they need, they are left stuck in hospital, which is worse for them and more expensive for the taxpayer. That is why the next Labour Government will agree a 10-year plan with the NHS to shift the focus of healthcare out of the hospital, into the community and closer to patients, which is where it should be.

Marsha de Cordova: My hon. Friend makes an excellent case, showing that Labour is the only party with a plan to deliver for the NHS. He will know that prevention and early intervention are key for people who are losing their sight. More than 650,000 people are currently on waiting lists. We know that 50% of all sight loss is avoidable, but many people are completely losing their sight because they are not getting early intervention and appointments. Does he agree that the Government need to get on with having a plan to tackle the eye health crisis in our NHS?

Wes Streeting: My hon. Friend has campaigned so determinedly on the issue, and she is absolutely right. When I spoke about self-referral in an interview with The Times, it was partly with ophthalmology in mind. In the vast majority of cases and for the vast majority of conditions, self-referral will not be appropriate and it is right that people see a GP before being referred to specialist services. But when people go and see someone who is trained and qualified to investigate their eyes, and that person makes a clinical judgment that they need to see a specialist, how can it be that, rather than being referred straight to the specialist, they are sent off to a GP first? That is absolutely crazy. It is wasting valuable doctors’ appointments and is lengthening waiting times for patients.
Labour is willing to look with an open mind at how we improve the patient journey. It is that fresh thinking that the NHS needs and is so badly missing from this Government. That touches on what I have been saying about the need to fix the front door to the NHS in primary care, with more care in the community. Our plan to recruit more doctors will deliver better access to GPs and ease pressure on accident and emergency departments.
We have to take a look at the GP partnership model, which under this Government is withering on the vine. By 2026, a majority of GPs will be salaried. There are three routes: let it wither on the vine, as the Conservatives are doing; accept that it is in decline and have something better to follow as it phases out over time, which is how we would approach it; or accept that GP partnership  is valuable, in which case we should rebuild it. I am open-minded about whether we phase out GP partnerships   or whether we rebuild general practice, but what we cannot do is what the Conservatives are doing, which is allowing general practice to wither on the vine. That is exactly what they have done.
Do you know what I found most remarkable today, Mr Deputy Speaker? In advance of this debate, I received a letter from the Minister, no less—the hon. Member for Harborough (Neil O’Brien), who is unfortunately not in his place—telling me that the current system of general practice is working. Bad news for you guys sat opposite, who are facing the patients and the voters at the next general election: your Ministers think that general practice is working. Your Ministers are therefore not looking at plans to fix it. Your Ministers are leaving you hanging out to dry at the next general election, because patients can see that only Labour is thinking about how to fix the front door to the NHS and rebuild general practice.
Our plan to recruit 8,500 mental health workers and provide community mental health clubs in every community—a plan championed by my hon. Friend the Member for Tooting (Dr Allin-Khan)—will deliver faster treatment, supporting schools and easing pressure on hospitals, as well as general practice.
Then there is the exit door of the hospitals to social care. Labour’s commitment to deliver better pay and better terms and conditions for care workers will reduce the 400,000 delayed discharges every month and provide a better quality of care for not just older people but working-age disabled people. There are so many people in hospital who would not need to be there if we could provide quality care in their homes, which is why our commitment to double the number of district nurses qualifying every year is central to our policy. We will also give every child a healthy start to life, with 5,000 more health visitors. [Interruption.]
The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield) has just said, from a sedentary position, “We need more GPs.” I know we need more GPs. Patients know we need more GPs. So why have the Government cut more than 5,000 GPs in the last decade?

Rachael Maskell: We have seen 13 years of failure in social care, with promises made and nothing ever delivered. There are now 165,000 social care vacancies, which is why the NHS is logjammed. Does my hon. Friend agree that it is time to pay our social workers a fair wage? Agenda for Change is a framework already built; let us give social workers a decent wage for the excellent work that they do.

Wes Streeting: My hon. Friend has consistently made the powerful case that pay and terms and conditions are directly linked to retention. No wonder we are losing so many people, not just from the NHS but from social care, to other employers in sectors such as retail. Earlier today, in this Chamber, I heard the Prime Minister say that as the minimum wage increased care workers would benefit, which tells us that care professionals are on the minimum wage while doing a really difficult job. No wonder they are going off to other jobs that cause less stress and anxiety and are better paid. This is not the way to run a social care system. We understand that, but the Government do not.

Vicky Ford: Will the hon. Gentleman give way?

Wes Streeting: No, because I must conclude my speech now. So many other Members want to speak that it would be unfair to take up more of their time.
This year marks the 75th anniversary of the NHS. For 75 years it has been there for us when we need it, founded by Labour but built by the British people, a public service, publicly funded, free at the point of need. Those are the values that are written into the DNA of the NHS. They are British values, they are Labour values, and it now falls to us, the party that created the NHS, to make sure that it is fit for the future.
I know, and the Opposition know, that the biggest obstacle to that change is no longer a busted, discredited Conservative Government on their way out, but the belief among too many people in our country that voting does not change anything, that politics does not matter, and that things cannot get better. I urge people throughout the country to ask themselves this simple question: are you better off than you were 13 years ago? Are your NHS services better off than they were 13 years ago? Are your public services better off than they were 13 years ago?
Labour has a plan; the Conservatives do not. Labour has a proud record of 13 years in government; the Conservatives do not. Only Labour can offer Britain the fresh start that it needs.

Several hon. Members: rose—

Nigel Evans: Order. As Members can see, there is a great deal of interest in this debate. Before I call the Secretary of State to move the amendment, let me advise Back Benchers that we will start with a speaking limit of five minutes, but that will rapidly be reduced so that we can get as many people in as we possibly can.

Steve Barclay: I beg to move an amendment, to leave out from “House” to end and add:
“pays tribute to the work done by the National Health Service and recognises that there are pressures on health systems around the world; recognises that all parts of the UK are facing pressures; welcomes that the Government has committed to reduce waiting times in England as part of its strategy to strengthen the NHS and care system with up to £14.1 billion additional funding being made available by government over the next two years to improve urgent and emergency care and tackle the backlog—the highest spend on health and care in any government’s history; and regrets that the Scottish and Welsh governments have refused to make similar such commitments.”
I am grateful for the opportunity to update the House further to my statement on Monday, in which I recognised the very real pressures faced by the NHS, particularly in emergency departments and with ambulance handovers, and the fact that the experience had not been acceptable for some patients and staff in recent weeks. I set out a range of actions that we are taking in response to those pressures—pressures that are being experienced by healthcare systems throughout the United Kingdom, and in Europe and beyond.
Before I turn to the honourable Opposition’s flawed motion, I want to reflect on a few points that the hon. Member for Ilford North (Wes Streeting) did not cover. For a start, he hardly mentioned social care, although that was an issue raised on his own Benches. We have made £2.8 billion and £4.7 billion available for social care in each of the next two years, recognising that what happens in one part of the system impacts the other. He also failed to mention any of our life sciences success stories, such as our 10-year partnership with Moderna, our deal with BioNTech to give 10,000 people early access to cancer therapies, and how we were the first country in the world to have the bivalent vaccines. That kind of work will shift the dial on prevention.

Karin Smyth: Will the Secretary of State give way?

Steve Barclay: I will, and perhaps the hon. Lady will explain why none of her Welsh colleagues is here for the debate.

Karin Smyth: I speak for the people of Bristol South. Let me talk about social care: can the Secretary of State explain why he will not publish information about the trailblazers on social care? The Government made a huge commitment to people in this country that they would fix social care, but they have reneged on that promise. They spent £2.9 million on trailblazers. I have asked written parliamentary questions of the Secretary of State and have been told that they are not publishing information. We do not know what has happened to that money. We do not know the outcome of that trailblazers report. If we are to learn from the disaster of the last year in which the Government marched us up the hill and back down again, we need to understand the outcomes. Will he commit to publish the evidence that we have had thus far?

Steve Barclay: I support transparency, so I will take away the issue of trailblazers that she raises. [Interruption.] The hon. Member for Wallasey (Dame Angela Eagle) chunters from a sedentary position, but I am agreeing to look at the point that the hon. Member for Bristol South (Karin Smyth) raises. She and I have debated in the past, not least when I was a Minister of State and she raised the issue of NHS property. She knows that I was a supporter then of transparency. She raises an interesting point that has not been raised with me previously.
I am very happy to take that away and look at how we get some transparency on that, because it is important that the House is able to see the evaluation of innovation and where pilots are done. Secondly, one of the challenges that the NHS faces is that it does not adopt that innovation at scale. The substance of the hon. Lady’s point is fair and I will happily take it away. On why I mentioned Welsh MPs, given Bristol’s proximity I thought she may be able to shine a light on the strange absence of any Welsh MPs, unlike the Secretary of State for Wales who is taking a keen interest in this debate.
I turn to the motion moved by the shadow Secretary of State, which seems, incidentally, to have been written before my statement on Monday. I might have thought that he would change it. We set out a further £250 million to support emergency departments and to get those  patients out of hospital who are medically fit to be discharged. Across the House, people recognise that the pandemic has had a significant impact on that. It effects flow in hospitals and it is an area of common ground between the shadow Secretary of State and me: the issue of delayed discharge is a big factor in the compression in emergency departments.

Dean Russell: My right hon. Friend’s visit to Watford just last week highlighted the incredible innovation there in virtual hospitals and the power of people being looked after at home. I know the work area that he looked at; I would like his opinion on that fantastic visit and on how we can roll that out across the country.

Steve Barclay: My hon. Friend highlights an extremely important area of innovation that speaks to the point about how to adopt that at scale. I will come on to the issue of virtual wards. At Watford, they told me that it was saving the equivalent of another ward of the hospital by enabling people to be discharged to recover in their homes where it was more comfortable. Patient satisfaction was extremely high—over 90% in the programme in Watford. Not only that; the clinical wraparound support means that if they need to return to hospital, they are able to do so.

Daisy Cooper: I, too, have seen the virtual ward at Watford General Hospital, which serves my constituents. We are very proud in west Hertfordshire that we were the first hospital trust to have that virtual ward, but he will know from his visit that the No. 1 priority of every member of clinical staff in that hospital is to have funding from the new hospitals programme to improve our hospitals in Watford, Hemel and St Albans. Could the Secretary of State please pledge to write to me within the next seven days to report on his meeting with the hospital trust and tell us whether and when we will finally get some funding, after being overlooked for decades?

Steve Barclay: It was extremely helpful to discuss the priorities for the new hospital build with the clinical team and the leadership team at Watford. I could see that for myself, and we are committed to it. This is an issue that my hon. Friend the Member for Watford (Dean Russell) champions assiduously on behalf of the people of Watford, but I know that it matters to a wider cohort there and I am happy to write further to the hon. Lady as she requests.
The virtual ward at Watford—it is great to have cross-party support for that innovation—is further facilitated by the funding we announced in the autumn statement: the further £500 million this year, £600 million next year and £1 billion the year after. The Opposition say we are “failing to recognise” the scale of the current challenges in the NHS, yet when I set out in the statement the additional actions that we are taking, it was both to respond to the pressures from flu—the sevenfold increase we have seen, with 100 times the number of patients in hospital with flu compared with last year—and to facilitate the innovation that they highlight in programmes such as virtual wards.

Debbie Abrahams: The Health Secretary will be aware that our hospital bed numbers are approximately half the OECD average, at fewer than 2.5 per 1,000 compared with 5 per 1,000 in the OECD. He will also have read reports in The Observer about the facility that was made available in the Health and Social Care Act 2012 that allows hospitals to allocate up to 49% of their hospital beds to private patients. Does he regret that?

Steve Barclay: The issue of bed capacity does indeed matter. I made the point a few moments ago that flow in hospitals is obviously constrained when bed numbers are high. That is exactly why, in the statement on Monday, I highlighted the importance of discharge, and of things like discharge lounges so that we can better facilitate those patients that are free to leave. But this is not simply about hospital bed capacity; it is about step-down intermediate care capacity and also, as we heard a moment ago, about the innovation that means we are better able to facilitate those patients who want to recover at home but want the safety net of some clinical support when they are doing so. It is about looking at the capacity in the whole of the system, not simply in the hospital; otherwise, the hospital itself becomes a magnet.

Angela Eagle: The crisis this winter was predictable and building long before we arrived here. Normally, the NHS and the Department plan for winter crises in the summer months, but this year something else was going on in the summer months, wasn’t it? The Tory leadership election. Does the Secretary of State regret what the distraction of the Tories’ internal faction fighting has led to, which is the inability of this Government to plan ahead and do the day job, and the fall below minimum standards  of the Government service?

Steve Barclay: I do not think those are factors that affected what happened in Scotland, where the First Minister warned on Monday that the hospitals were almost completely full. Indeed, the Scottish Government are taking emergency measures, including cancelling some non-essential operations. I do not think that was a factor in France, where the French Health Ministry is saying that intensive care beds are at saturation point. I do not think that was a factor in Wales, where more than 54,000 patients are waiting more than two years for an operation. I am glad that the hon. Lady highlights the summer, because it was in the summer that we hit the first of our elective recovery targets in terms of the two-year wait, getting those below 2,000, in stark contrast to what we saw in Wales. The surge in flu has happened across the United Kingdom, not just in England, and it has also affected France, Germany and other countries in Europe.

John Redwood: I am very conscious that this Government have put a lot of extra money into the health service, and that Ministers have consistently wanted to get waiting lists down so that we have the extra capacity we need. Will the Secretary of State share a little of the thinking of senior management, who run the NHS day to day, in not using more of that resource for extra beds and extra staff to back them up?

Steve Barclay: As so often, my right hon. Friend raises an extremely important point about how we best use the resources and significant investment being put into the NHS. He will recognise that a key part of delivering value for money is looking at the interfaces on the patient pathway through the healthcare system. Handover points are often when we have the most difficulty.
I am sure my right hon. Friend will welcome that I recently visited Maidstone to see how we track the patient journey through a hospital and into care—residential care or domiciliary care. We are putting control centres in place through the 42 ICBs, and our reforms are bringing health and social care closer together. An area of common ground across the House is on the need to bring social care and healthcare closer together, and the ICBs, which were operationalised from July 2022, are a key part of that.
I suspect that one issue on which my right hon. Friend and I strongly agree is that it has to be underscored by data, so that we can see where the blockages are and prioritise the use of technology, such as machine learning, artificial intelligence, virtual wards and other innovations.

Clive Efford: Will the Secretary of State give way?

Steve Barclay: I am being pretty reasonable on interventions, so if the hon. Gentleman will give me a moment.

Clive Efford: rose—

Steve Barclay: The Opposition want to hear what the Government are doing, and then they tell me that they do not want to hear.

Clive Efford: The Association of Directors of Adult Social Services surveyed English local authorities back in 2019, and it found that they had endured cuts of £6.3 billion in adult social care, resulting in a drop since 2014 of 425,000 beds. How much does the Secretary of State think that has contributed to today’s crisis?

Steve Barclay: I am delighted that the hon. Gentleman raises the additional funding that the Government are putting into social care. In his autumn statement, the Chancellor made the biggest social care spending increase of any Government in history: an extra £2.8 billion next year and £4.7 billion the year after. That is £7.5 billion over two years, on top of the £6.6 billion he put into the NHS over two years. At a time when, as a consequence of the pandemic and the war in Ukraine, inflation is extremely high and there are acute cost of living pressures for constituents across the country, the Chancellor prioritised spending not just on health but, as the hon. Member for Eltham (Clive Efford) helpfully highlighted, on social care. Bringing health and social care together is exactly what I set out in my statement to the House on Monday.

Imran Hussain: Will the Secretary of State give way?

Steve Barclay: I will take one further intervention, and then I will make some progress.

Imran Hussain: The Secretary of State refers to significant challenges, as though this crisis started a few weeks ago. This crisis has been ongoing for more than a decade,  and it is worsening year on year, but Ministers come here blaming it on anything other than, frankly, their incompetence and negligence over the last decade. When will they wake up, move away from their ivory tower and accept that it is on their watch that their incompetence and negligence have resulted in our constituents suffering today?

Steve Barclay: The data shows very clearly the profound impact of the pandemic, and the data shows that the impact is not constrained to England. It is acute in—[Interruption.] The hon. Member for Bradford East (Imran Hussain) has just had his intervention. If he wants to hear the answer, the reality is that the pandemic has had a profound impact on the NHS in Wales and Scotland, just as it has across Europe. That is what he is ignoring. He does not like the facts, but the facts are clear.

Imran Hussain: rose—

Steve Barclay: I will answer the hon. Gentleman’s first question. I will then give him a second go, as he is chuntering. Hospital flu admissions went up sevenfold in a month. The figure is 100 times higher this year than last year, and that comes on top of the severe pressure from the pandemic—9,000 cases. Perhaps he wants to explain the situation in Wales and why he feels the pandemic has not had an effect.

Imran Hussain: Of course, the Minister did not answer my question. I ask him about two things. First, every time this Government are put on the spot, they refer to what has become the Welsh defence; they would much rather not talk about their own incompetence. Secondly, how does he explain that in at least seven of the past 12 years they have missed their target overwhelmingly? That suggests we were in a crisis a long time ago.

Steve Barclay: Again, I can understand why the hon. Gentleman does not want to talk about the performance of the Welsh Government, but I was talking about the Scottish, French and German Governments, and about the fact that the pandemic has had a severe impact across the UK and across Europe.

Grahame Morris: rose—

Steve Barclay: I know that the hon. Gentleman has been keen to get in, so I will give way, but then I must make some progress.

Grahame Morris: I am grateful to the Health Secretary for that. On the point about relative performance, I want to touch on cancer treatment capacity. Our performance as a nation is lamentable on the seven most common forms of cancer. If the buzzword is innovation, surely we have a tremendous opportunity to roll out advanced radiotherapy. About one fifth of the machines we have in our hospitals are more than the recommended limit of 10 years old. Surely that is a perfect example of a cost-effective means by which we could apply artificial intelligence and diagnostics in parallel, and we could treat many more patients and improve outcomes. Is he open to that idea?

Steve Barclay: I am very open to that idea. For all the sound and fury that there sometimes is within the political debate, I know that there are certain topics within health on which people across the House are keen to work. Cancer is one issue that affects all families and all constituencies, and there is often scope to work extremely closely together on it. Knowing the hon. Gentleman well, I am happy to work with him moving forward.

Tim Farron: rose—

Steve Barclay: May I just answer the last point, as the hon. Member for Easington (Grahame Morris) raised an important issue, and one that matters to many families? On the substance of his point about equipment, tech and innovation, we are looking at how we innovate. GP direct access is part of that, as it provides direct access to diagnostics. More patients are having their first cancer consultation following an urgent GP appointment. If we take the cohort of more than 810,000 who have started treatment for cancer since March 2020, the statistics show that 94% did so within their first month.
Given the seniority of the hon. Member for Westmorland and Lonsdale (Tim Farron), I will take his intervention, but then I must make some progress.

Tim Farron: I wanted to seize the moment, based on the excellent question from the hon. Member for Easington (Grahame Morris). The inquiry by the all-party group for radiotherapy is on 18 January, but we have not had a response to our request for the Secretary of State, or indeed any of his ministerial team, to attend. Will at least one of them do so?

Steve Barclay: Let me check the diaries with the Department. These things are always dangerous because we need to know what the travel plans and various commitments are, but I hear the hon. Gentleman and the hon. Member for Easington, and we will absolutely look at what can be done.

Vicky Ford: As a declaration of interest, let me say that I am the daughter of two NHS doctors, the sister of a geriatrician and the wife of an oncologist. I hope that the shadow Secretary of State shows a bit more respect in the future for those of us who come from medical families. I thank my right hon. Friend the Secretary of State for giving way, given that the Opposition were not allowing me to ask my question.
We know that it takes a long time to train doctors. Before the last interventions, the Secretary of State mentioned the Chancellor. One excellent thing the Chancellor did when he was Health Secretary was to announce 10 new medical schools. We have always had a shortage of doctors in Essex and difficulty recruiting them, because we had never trained doctors there. The medical school in Chelmsford is brilliant. Its attrition rate is less than half the national average. The first students will qualify this year, and it is fantastic. Those students want to stay locally. This is a symbol of the Conservative party investing in the long-term future of the NHS where it is needed. Will the Secretary of State consider expanding these excellent medical schools?

Steve Barclay: My right hon. Friend raises an extremely important matter. I was in the Department when the current Chancellor was Secretary of State and when we made that commitment to a 25% expansion in medical undergraduate places. She is absolutely right in saying that it takes time for those cohorts to come through. She is also right that Chelmsford has been a huge success. I am sure that, in the context of the workforce strategy that NHS England colleagues are bringing forward, she will make the case for where any additional capacity should go, but we will, of course, look to that workforce strategy to map out what is needed.
Let me turn to elective care backlogs. A number of Members across the House have raised the issue of the 7.2 million people on the waiting list. I think that it is worth breaking that figure down between the 1 million who require surgery and the 6 million who are waiting for outpatient appointments—either for their first appointment or for their follow-up. The NHS is doing more than 94 million outpatient appointments a year, of which 30 million are for new patients and 64 million are follow-ups. The “did not attend” rate is about 6.5%. This relates to the question of my right hon. Friend the Member for Wokingham (John Redwood) about value for money and how we deliver the reform of which he spoke. If we halved the “did not attend” rate of about 6.5%, it would free up almost 4 million slots. I am very interested in looking at the data and at how we prioritise within that data the wider challenge around the elective care backlog. I hope that that provides him with some reassurance.

Margaret Greenwood: Will the Secretary of State give way?

Steve Barclay: Yes, I will.

Nigel Evans: Before the intervention is taken, I advise Members that there is a lot of interest in this debate, and each intervention is cutting into the contributions that can be made. We will be down to a three-minute limit very quickly, and some people still may not get in.

Margaret Greenwood: I wish to bring the Secretary of State back to the point raised by my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), who pointed out that in the Health and Social Care Act 2012, the coalition Government legislated to allow NHS hospitals to make up to 49% of their money from private patients. She asked whether he regretted that, but we did not get a response, so I would like to hear the Secretary of State’s response. Will he also tell us what assessment he has made of the impact on waiting lists of non-NHS patients taking the place of NHS patients in our hospitals?

Steve Barclay: It is a good thing to be bringing more funding into healthcare rather than turning it away. However, conscious of your edict, Mr Deputy Speaker, I will truncate some of the areas that I was going to cover, because I am sure that right hon. and hon. Members will bring out some of those points in the wider debate.
Labour’s motion ignores the statement that I gave to the House on Monday. It ignores the extra funding that we provided in the autumn statement and the commitment reflected in the Downing Street summit on Saturday to  publish recovery plans for urgent and emergency care and for primary care, which we will do in the weeks ahead. The motion ignores the very real health challenges being experienced across the United Kingdom in Wales, Scotland and Northern Ireland, which all face pressures. It ignores the fact that France, Germany and elsewhere in Europe also face significant pressure.
The Government recognise, as I set out to the House on Monday, that there are real challenges in the NHS and social care. That is why we set out a three-phase approach: first, taking immediate steps to reintroduce flow to relieve pressure in the emergency department and across the hospital estate; secondly, putting in more capacity to build greater resilience over the course of the year, mindful of the fact that summer is increasingly a busy period—more so than was traditionally the case; and thirdly, making investments in our life science industry, such as the deals with Moderna and BioNTech, to ensure that patients in the UK get the most innovative drugs at the earliest date. That shows the Government’s commitment to backing the NHS now and in the future, which is why I commend the amendment to the motion to the House.

Several hon. Members: rose—

Nigel Evans: Before I call Barbara Keeley, I remind everybody again that interventions eat into the time of those at the end of the speaking list, so please have a little bit of care and consideration for your colleagues.

Barbara Keeley: First, I want to share with the Health and Social Care Secretary my constituent’s recent battle to get medicine for his son, who had a high fever and symptoms that could be strep A. Unable to get a GP appointment, my constituent and his son had to travel out of the area to a local walk-in centre. They were then sent to the hospital, where they endured a six-hour wait. When the child was eventually examined, he was prescribed amoxicillin, but it was another long battle to find a pharmacist who stocked the antibiotics needed. My constituent said:
“Even I am shocked with what I have experienced over the last 24 hours.”
More and more people are finding out that the health service is no longer there for them when they need it. When someone has a child with serious symptoms and a temperature over 40°C, they should be able to access care quickly and not be forced to drive around for miles in desperation. My constituent also told me that he ran into several other parents that day who were experiencing the same issues in trying to get appointments and medicine for their children, who were very ill.
Nurses, doctors, ambulance workers, pharmacists, administration support staff and all those who, as part of our national health service, pour their energy into helping people when they are sick are worthy of our deepest respect and our thanks. The NHS crisis is not of their making. It is caused by the inability of the Conservative Government to plan or to support our health services adequately.
Many clinicians and commentators looking at the NHS crisis this week have raised the question of social care. Every year we revisit the pressures on social care and the desperate need for reform. Every year we see the  consequences of Government inaction. We have had promise after promise of reform, but that reform is always dropped in favour of sticking-plaster solutions.
This week’s sticking-plaster solution gave the NHS some extra money, apparently to buy care beds. The deeper issue in social care is not beds, but the crisis in the social care workforce, with 165,000 posts vacant, representing one in 10 of the workforce. The NHS can buy beds in care and nursing homes, but that home may not have the appropriate staff available for the needs of the person being discharged. Unsuitable care will only lead to readmissions to hospital, so the cycle carries on. We know that in some parts of the country there are care deserts where there are no care home places. Does that mean that hospitals will start buying care home places tens or even hundreds of miles away?
The scandal of out-of-area placements is already a reality for many autistic people and people with learning disabilities. Chronic underfunding of social care and the lack of appropriate community services have entrenched a reliance on expensive in-patient care for autistic people and people with learning disabilities—care that is often far from home and not suited to the person’s needs. There is no extra funding to solve that problem. Indeed, the budget for those community services has been reduced this year from £62 million to £51 million.
We know that 2,000 autistic people and people with learning disabilities are trapped in that inappropriate in-patient care, which is often found to rely on the overuse of punitive seclusion and restraint. The fact that many placements are hundreds of miles away from family and friends makes the problem worse. Despite the steady stream of scandals, from Winterbourne View 11 years ago to the Edenfield Centre more recently, it is an issue that the Conservative Government choose to forget, even though it is destroying the lives of many of those detained and their families.
Our Opposition motion rightly ends with a call on the Government to
“end delayed hospital discharges…and reform primary and community care”.
Thirteen years of Conservative failure have led to this crisis. It will take a Labour Government to make the NHS fit for the future.

Steve Brine: I only have a short time, so I will make a couple of points.
On strikes, since we have a major strike today, I understand that many of the trade unions are saying they will not engage with the independent pay review bodies for the 2023-24 settlement. That is a catastrophic mistake on their part. The shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), and I were on a well-known evening news programme together the other night. Far from trashing the pay review body, he said that although it may need reform, it is important. I am glad to hear him say that, because it is important, and the alternative is Ministers directly negotiating pay settlements with unions. They have tried to do that in Scotland in recent weeks, and the Royal College of Nursing rejected the offer out of hand. The pay review process may not be perfect and may need reform—our Select Committee hopes to talk to the NHS pay review body soon—but I think that madness lies in pay negotiations  around beer and sandwiches in Ministers’ offices. The unions should engage with the pay review process for next year. That would be the smart thing to do on their part.
My second point is about demand. The GMB came before the Select Committee just before Christmas and told us that the number of calls coming into the ambulance service is about 10 times what it was pre-covid. There are 100 times the number of people with flu in the acute setting than at this time last year. Demand is significantly outstripping supply in the health service right now, and I think it is disingenuous not to face that.

Aaron Bell: I am grateful to my hon. Friend for his work in chairing the Select Committee, and for the joint session with the Science and Technology Committee, on which I sit, about the lessons learned from covid. We heard that there are lessons for the NHS to learn for the future. Does he not find it a bit strange that there is no mention whatever of covid in the Opposition’s motion? Clearly, covid—combined with flu and everything else that he talks about—is one of the reasons behind the acute pressures that we have experienced this winter.

Steve Brine: I said in the House on Monday that covid has put the health service on its knees—it has done so to health services in the UK and around the world. To repeat what I have just said, it is disingenuous to suggest that the problems faced by our health service right now are not caused by our covid experience. The number of people presenting with suspected cancers is through the roof. That is good—many of those cases will turn out not to be cancer, which is even better—but so many people are coming forward because we suppressed demand during that time, and it is adding to the demand outstripping the supply in the health service right now.

Karin Smyth: The hon. Gentleman chairs the Select Committee, so it is really important that he is clear about this. The Government ran the health service at 96% capacity well through the 2010s, well before the pandemic. They were consistently warned that 96% capacity is too much; we should be running at about 85% capacity for staffing and so on. Capacity in the system has been our problem for a long time. Demand is outstripping capacity—supply is about capacity—and he, as Chair of the Health and Social Care Committee, needs to be clear about that point.

Steve Brine: I will choose my words and the hon. Lady can choose hers. I will come to capacity in the conclusion of my remarks—I promise her that.
I will touch on patient flow. Any acute sector that I speak to or visit at the moment is saying clearly that patient flow is hampering everything happening at the front door and the back door. One of the reasons why those in the ambulance service are striking is that they are so heartbroken about not being able to deliver the service that they want to deliver and cannot get out on the road because they are waiting to dispatch their patients.
I said it on Monday and I will say it again now: I welcome the £250 million that the Government have put forward to buy beds. I repeat that two thirds of social  care is domiciliary care—care in people’s homes—and we must not forget that, because it is important to getting people through the acute system. The modular work that the Secretary of State talked about—modular units in and around emergency departments—to add extra capacity and meet some of the extra demand coming through the front door, is also very welcome.
I said that we have to separate the now from the long term, so let me address the long term. The elective recovery taskforce is important; the 15 new elective hubs are important. At Prime Minister’s questions today, the Prime Minister talked about eliminating the two-year wait, and that is good—it is not, of course, the extent of his ambition, and to say so is facile. We do not yet have an elective hub in Winchester. The Secretary of State knows that I am on his case about it, but may I just land that point with him again? The Prime Minister’s primary emergency care plan, which we eagerly expect later this month, will be important. It is also part of a long-term strategy and plan, and I think many people in the ambulance service will be pleased with what they see there. I hope that it will be as ambitious as what we hear in some of the rumours.
Some of the things the Select Committee is looking at feed into what the Secretary of State and the Government are doing. Integrated care systems are a creation of this Government. They are about flattening services across the NHS and breaking down those barriers between health and social care. We are in the middle of a big inquiry into integrated care systems, and we are liaising with the Hewitt review, which is a good thing. We were talking to the Care Quality Commission this week, and the Government have not yet laid the regulations on how the CQC will look at ICSs. Will the Minister please look at that?
This morning we talked about the digital transformation of the NHS. There are huge dividends in digital for the NHS, including simple things, such as the amount of money that the NHS spends on sending letters to patients—not least given that they never get there due to Royal Mail strikes. There are clinical dangers to that. Let us pursue our digital transformation, and I know that the Secretary of State is up for that. In terms of the stuff we will be doing this year, we eagerly await the workforce plan.

Maria Eagle: Will the hon. Member give way?

Steve Brine: I cannot give way, because I do not have any more time. We eagerly await the workforce plan. When the Minister sums up, will she update us on where we are with the workplace plan and its independent verification, which the Chancellor announced in the autumn statement?
The Select Committee will be looking significantly at prevention this year. I know that the Secretary of State is passionate about some of the upstream prevention measures we will be talking about, and I look forward to him coming before the Select Committee on 31 January to talk to us—many of my fellow Committee members are here—about the work we are doing. I am excited about our work on the future of cancer. We hear all this evidence about there being cancer plans around Europe that lead to better outcomes, so I want to see the new cancer plan.
Finally, we need to be very careful about the language we use and how we talk about the NHS. Are we honest about the reform we need? Do we believe in the independent pay process? Is primary care really fit for purpose as it is? Do the British people want to spend more than the £159 billion that we will spend this year, and how will we pay for it? I think we do need a bigger NHS, and we clearly need more people in the NHS—that is not a point of debate—but we need to be careful about the language we use around the NHS, because otherwise the long-term strategy is nothing more than a moot point of debate in this House.

Valerie Vaz: It is a pleasure to follow my friend the hon. Member for Winchester (Steve Brine), the new Chair of the Select Committee. My hon. Friend the Member for Ilford North (Wes Streeting), the shadow Secretary of State, is right about Government mismanagement of the NHS since 2010. As a member of the Health Committee from 2010 to 2015, when it was chaired by the right hon. Stephen Dorrell, the former Health Secretary, I want to set out why this crisis has been brewing since 2010. Incidentally, Stephen Dorrell has noted five mistakes that the Government have made and should look at.
The Health and Social Care Act 2012 prevented integration. It made the NHS not the first and default option, and it was opened up to privatisation, fragmented and destabilised. The reorganisation was described as so big that it could be seen from space, and it was opposed by so many that it had to be paused. Despite the pressures of the pandemic, we had a further reorganisation with the Health and Care Act 2022, under which we will not have CCGs any more, but integrated care boards.
His Majesty’s Opposition have been pushing integrated care since before 2010. Our Select Committee visited Torbay in 2009, during the last Labour Government. We saw the single-point entry of Mrs Smith, who could be tracked from the start—from a single phone call—to hospital and out again, with any of her needs met by an upscaled, co-located team. However, the 2012 Act stopped that pooling of resources. Integrated care can only work if there are adequate resources for local authorities. Austerity measures since 2010 have starved local authorities and other public services of funding. Clinicians should be at the heart of the NHS. People who use it or work in it do not get a say.
In 2016 the then Secretary of State, now Chancellor, picked a fight with the junior doctors. I met them outside Richmond House. We have had more mismanagement, with £347 million for a covid testing contract to Randox, which then had to be recalled because of concerns about contamination. Now we have PPE Medpro, and today the Public Accounts Committee said the Government have mismanaged the economy by losing £42 billion in uncollected taxes. There is money, but not the will to find it.
Nurses went on strike in December, yet in the first statement the Secretary of State has made since—he is not in the Chamber, but he said that we did not mention his statement—he did not mention the workforce at all. In fact, he gave an understatement of the figures for people with delayed discharge. He said that there were  just 6,000 cases in June 2020. Last year, there were 12,000 to 13,000 a day. The Government knew the figures, but they did nothing—they had no plan.
Not talking to a workforce who stepped up into the unknown during the pandemic is mismanagement. Stopping nurses’ bursaries was mismanagement. Not holding cross-party talks to solve the care crisis when we urged them to—the Health Committee report was in 2012—was mismanagement. The Government dismantling a health service that had its highest satisfaction levels in 2010, when Labour left office, is mismanagement.

Tahir Ali: On the workforce, existing nurses are underpaid, but the serious number of vacancies that existed in September—47,000, as reported by Nursing Times—must also be addressed adequately and immediately. Those vacancies are putting pressure on nurses, on top of the pay awards they are after.

Valerie Vaz: My hon. Friend is absolutely right and puts the point perfectly. I have questions to ask the Minister. Are the recommendations on safe staffing levels made by Sir Robert Francis being followed now? Will the Secretary of State consider a patient discharge dashboard so we can see the figures on a weekly basis? Where is the accountability for the £500 million in the discharge fund? Are the 42 NHS system control centres mentioned in the statement just the ICBs by a different name? Our shadow Secretary of State for Health has outlined a plan for training more doctors, paid for by abolishing non-doms, and I am with him on salaried GPs as a step in the right direction.
Nye Bevan heard the cries of his community in the valleys. He said:
“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”
He turned his dream into a wonderful service that is free for all of us. We will not let this flailing and failing Government destroy our NHS.

Alun Cairns: I must admit that I was surprised by the audacity and tone that the hon. Member for Ilford North (Wes Streeting) took when introducing such an important debate. Not one Welsh Member of Parliament from the Labour party is present. I think they may share my disappointment in the tone the Labour party is taking over this serious issue, bearing in mind the performance of the Labour party and Government in Wales in failing to deliver on the NHS. Who knows, those Members might be embarrassed or angry; maybe they are angry and embarrassed at the hon. Member for Ilford North. I hope they are certainly disappointed by the performance, waiting times and outcomes for our constituents in Wales.
Tone really does matter. This is a really important debate, and we need to consider it in the way the Secretary of State recognised the issues facing every part of the United Kingdom. The Chairman of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine), also recognised that and urged the use of responsible language. This needs to be followed through. When I have highlighted  deficiencies in the NHS in Wales in the past, I have been accused of undermining the NHS or attacking NHS staff. I hope I will not be accused of that now, as that is not my objective. I am instead frustrated with the Labour Government in Wales and the outcomes my constituents are experiencing. I make this contribution in support of the NHS staff, clinicians and all the apparatus that delivers an effective and efficient health service.
Much has been said about data and waiting times, and I could go on and on about that. No matter what statistic the hon. Member for Ilford North highlights, I could trump him every time with worse performance in Wales. I am not celebrating that, because my constituents and my family experience that performance. I am disappointed by the political tone the hon. Gentleman is taking in seeking to exploit the challenges facing the NHS and its staff having come out of a global pandemic. That is something we absolutely need to recognise.
I will highlight some statistics to encapsulate the experiences of my constituents and others in Wales. After 25 years of a Labour Administration in Wales, accident and emergency times, primary care delays, cancer treatment times and waiting lists are much longer than they are in England, or than they were previously. In England, 5% of patients are waiting longer than 12 months; in Wales, 23% of patients are waiting longer than 12 months. I will not bore everyone with lots of numbers, but I will take that to the next level of statistics: 7.9% of patients in Wales are waiting longer than two years for treatment. That is why Opposition Members have to accept and recognise that this a serious debate that affects every part of the United Kingdom, Europe and beyond.

Simon Baynes: Does my right hon. Friend agree not only that the statistics for Wales are markedly worse than for England, but that in Wales the expenditure per head on health is 15% higher than in England?

Alun Cairns: My hon. Friend makes an important point. The hon. Member for Ilford North pointed to the lack of funding for the NHS in Wales, but since 2010, only the Labour Government in Wales have ever cut NHS funding—no other Government in the UK have done that. When I was the Secretary of State for Wales, we renegotiated a funding formula that the First Minister, who was the Finance Minister at the time, said was a very fair deal. That formula means that Wales receives £120 for every £100 that is spent in England, and there is a funding floor attached to it. That highlights the generosity and fairness of the settlement, bearing in mind the inequality that the hon. Member for Ilford North highlighted earlier.
In my final minute, I will comment on the strike action. Every point that the Leader of the Opposition has made about the challenges of strikes, and every criticism that has been made of the Prime Minister and Secretary of State for Health and Social Care, could equally apply to the First Minister and Health Minister in the Welsh Government. That demonstrates the complexity of the situation. The Welsh Government say that they cannot act until they have more money, but they need to remember that they are getting £120 for  every £100 that is made available in England, and they have tax-varying powers. Are they saying that they want to tax the English more in order to spend more in Wales? They can vary taxes however they want—[Interruption.] They can vary taxes and that is the choice that they have to make. They decide where they spend their money. In closing—

Nigel Evans: Order. Sorry, time is up. We have to be fair to everybody.

Angela Eagle: Through neglect, ideological hostility and incompetence, the Tory Government are presiding over the worst crisis the NHS has ever seen. Some 7.3 million people are on the waiting list; there has been a virtual collapse of emergency response; and people cannot see a GP or get follow-up treatment without unacceptably long waits. Today, there have been reports of more than 1,000 excess deaths a week—the highest total, excluding the pandemic, since 1951. There have been many, many preventable deaths on the Government’s watch, and each and every one is a tragedy.
Our NHS is in crisis from top to bottom. There are patients in hospital beds who cannot be discharged because there is no domiciliary care and nowhere for them to safely go. Ambulances are queuing for hours, unable to admit critically ill patients. There are inhumane waits in A&E before anyone can be admitted to beds they desperately need. Staff, who are already burnt out from the stresses of the pandemic, are unable to care properly for patients and are barely able to get through a shift because of the emotional exhaustion of having to deal with those failures.
A nurse at Arrowe Park in the Wirral, which serves my constituency, wrote to me recently. After 21 years of service to our NHS, she says she has
“never worked in such an unsafe environment”.
She says:
“Staff are literally on their knees, leaving shifts late in tears, and leaving in their droves”.
My constituent went on to detail a case in another local hospital in which a patient had a cardiac arrest in a hospital corridor. Frankly, a hospital should be the best place to have a cardiac arrest if somebody is going to have one, but it is now not so in Tory Britain. The individual collapsed and died.
With 132,000 NHS vacancies in England—over 17,800 in the north-west alone—our NHS is dangerously understaffed, under-resourced and under-respected. That is why NHS staff at the end of their tether have taken the desperate decision to go on strike. That is why any Government worth their salt would have decided to negotiate properly with them, to listen to them and to try to deal with and recognise that, in the last 13 years, a real-terms cut of 20% in nurses’ remuneration is simply not acceptable, but what did they do? They chose to have a divide-and-rule strategy, and they chose to try to scapegoat and blame NHS staff for the terrible conditions I have been talking about.
Perhaps the Government should consider legislating for a minimum service outside of strike days, because we are going to be in the absurd position of having, by law, guarantees on strike days—they could be negotiated  anyway and always have been—that do not apply on non-strike days. It is an insult when the Secretary of State meets the health unions and says they have to increase their productivity. They are working beyond any amount of time that any human being should be asked to work.

Dr Caroline Johnson: I confess to being a bit confused by the Labour party’s position on minimum service levels. We all want to ensure that our constituents are as safe as possible. The ambulance workers want to ensure that people are as safe as possible. The hon. Lady has said herself that these things would be negotiated anyway. But the challenge people face on the ground is not knowing who is going to come in, the fact that people do not have a say on whether they are going to come in and the fact that a negotiated settlement might be different in different areas of the country, which makes messaging and public health messaging very difficult and puts people at risk. So why is Labour so against minimum service guarantees?

Angela Eagle: I think the hon. Lady, and I know that she is a doctor, needs to recognise that these agreements have always been made when there have been strike days in the NHS—always. I think she also needs to recognise that any Government who were being responsible would have negotiated to put an end to these strikes, recognised the fantastic service that nurses have given and dealt with the issue, instead of going for confrontation.

Dr Caroline Johnson: Will the hon. Lady give way?

Angela Eagle: I am not giving way again.
I am going to leave the last parts of my speech to another constituent of mine, an 83-year-old who fell alone in his home and was left. The ambulance was called at 4.15 in the afternoon—it was thought he had a fractured hip—and he was warned of a potential 14-hour wait. My constituent said he
“naively thought this must be the worst case scenario and thought it was very unlikely to be that long”.
He could not move, he could not sleep and he could not go to the toilet. Eighteen hours later, the ambulance arrived—18 hours later—at 10.15 the following morning. At the hospital, things got no better. There were patients on trolleys lining the corridors. For nearly another 24 hours, this 83-year-old man immobilised with pain was to lie on a trolley in a hospital corridor after 18 hours of waiting for an ambulance.
This is in no way acceptable. This should not be accepted by any Government worth their salt. They should hang their head in shame at what they have done to our NHS. We need to have a Government finally, which we will after the next election, who will solve these problems, instead of seeking to blame everybody else—the weather, the pandemic, the staff and any number of other things. It is about time we had a Government who have the guts to take responsibility for the decisions they have made and put it right. We are going to have such a Government soon. Shamefully, we have not now.

Maggie Throup: I begin by paying tribute to the hardworking staff of our NHS, including those working across Erewash, whether at Ilkeston Community Hospital, in our GP practices or pharmacies, and those who work in the care sector.
On the creation of the national health service in 1948, the public information leaflet sent to every household in the country stated:
“Everyone—rich or poor, man, woman or child—can use it or any part of it. There are no charges, except for a few special items. There are no insurance qualifications. But it is not a “charity”. You are all paying for it, mainly as tax payers, and it will relieve your money worries in time of illness.”
At that time, average life expectancy for men and women was 66 and 70 respectively. Alongside heart disease and cancer, people were still dying in large numbers from what today are preventable diseases such as tuberculosis, polio, measles and diphtheria—all now preventable through vaccines.
Countless lives have been saved by the NHS since its inception, which is in no small part thanks to the increasing use of diagnostic testing. Often overlooked as the less sexy side of medicine, the field of diagnostics is so much more than a blood pressure check, X-ray or computerised tomography scan. A simple blood test provides a multitude of clinical information, leading to the diagnosis of complex medical conditions. More and more in-vitro diagnostic tests are available in a rapid format, giving almost instant results close to the patient. I am sure all Members in the Chamber today will have used a diagnostic test recently in the form of a lateral flow test for covid. Indeed, we will all have seen the benefits of such devices, which are a useful and invaluable tool that help to prevent serious illness and disease by diagnosing conditions at an early stage, allowing for timely treatment and helping to prevent more serious illnesses.
We are, however, yet to capitalise on the full potential of diagnostics as a way of relieving pressure in the NHS system, and helping to reduce the backlog—one of the Prime Minister’s top priorities. For example, the British In Vitro Diagnostics Association estimates that at least 3% of Accident and Emergency admissions are for chest pain symptoms. A simple but sensitive blood test for cardiac troponin can be used to rapidly diagnose or rule out a heart attack in patients attending A&E with chest pains, allowing for either early discharge or admission for further treatment. That could potentially save billions of pounds and is better for the patient, but it requires changes to well established protocols within the department, and links with the hospital laboratory. I am sure that is the type of change the Secretary of State was referring to when he spoke about productivity. This is about the productivity of procedures and processes that fully match the technology available today, rather than that available 74 years ago. I therefore seek the Minister’s assurance that in-vitro and in-vivo diagnostics will be given the recognition they justifiably deserve in all forward planning by her Department, as an effective way of reducing pressures on our NHS and social care services.
I believe this debate should be framed within a wider global context, and not localised just to issues affecting the NHS in the UK. The Guardian newspaper—a favourite of the Labour party—recently highlighted that in France more than 6 million people, including 600,000 with  chronic illnesses, do not have a regular GP, and 30% of the population does not have adequate access to health services. There are similar pictures in Germany, Spain—I could go on. This is a Europe-wide problem, and not a unique crisis in the NHS as Opposition Members would like the public to believe.
I believe the onus is also on us as individuals to use our precious resources appropriately. I hear from my local GPs that people are seeing them who have had a cough for just four hours, as opposed to four weeks, and that people phone 111 instead of 999, or 999 instead of 111. People turn up at A&E when they could have got great advice from their local pharmacy, and others do not appreciate that some of their lifestyle choices will have a huge negative impact on their health. There is still a lot of work to be done on simple and effective public messaging. We must all make our own contribution—both financial and from the perspective of personal responsibility—to ensure that the NHS remains viable because, like any form of insurance, although we may not need it today, we might well need it tomorrow.

Maria Eagle: My constituent Lynne O’Sullivan emailed me at 4.30 am last Sunday from the A&E department at Aintree University Hospital. She said:
“Good morning Maria. I email you in a last bid for help. I’ve been sat in Aintree hospital A&E since Friday…with my father who was sent here by his GP. We arrived at 10.30 on Friday with my father, who they think suffered a stroke. They admitted my dad…saying he needs an MRI scan and some other tests. We are still sat in A&E awaiting a bed on hard seats having slept here since Friday…It’s now our 42nd hour sat in A&E. I am at my wits’ end trying to get help. A doctor on Friday evening prescribed high blood pressure medication for my father. He has only received one dose.
I beg for your help. I don’t want to lose my dad due to poor hospital care”.
Well, who would?
Lynne’s father finally got a bed after 54 hours sat on a hard seat in A&E at Aintree hospital. He eventually got an MRI scan 78 hours after he attended the hospital—that was without him needing an ambulance. I am glad to say that Lynne’s father had not had a stroke and that he is in hospital now.
That is not one isolated example; there have been many other examples in Liverpool. On 27 December, the wait at Whiston Hospital A&E was 20 hours; by new year’s eve, it was 30 hours and people were being told not to go unless their condition was life-threatening. At the new Royal Liverpool, staff were having to go around with a big list telling people that there was a 30-hour wait for a bed. Somebody was reported as saying that a three-page list of people waiting for a bed had been touted around by one of the staff.
That is not only appalling for patients; it is terrible for staff. Right hon. and hon. Members may have seen the letter that top doctors at the new Royal Liverpool wrote to their management saying that they were “ashamed” of the “dreadful conditions” in the “chaotic” emergency department—that is in a brand-new hospital. They described the new Royal’s accident and emergency as  “overcrowded, chaotic and unpleasant”, with an “unacceptable and unsafe” reliance on corridor care. The letter stated:
“The need to utilise the waiting room and X-ray waiting area chairs to house patients awaiting admission is completely unacceptable.”
They also said that they were
“embarrassed, ashamed and demoralised by the standard of care”
that they were able to provide. Yet what have we heard from the Government?
I am sorry that the Secretary of State is no longer in his place, but I am afraid that today he has come across as complacent, as he did on Monday when he gave a statement to the House. He disappeared over Christmas. There is no point in talking about winter pressures in January—it is too little and too late if one is having to talk about it in January. There needs to be planning well in advance. He has come across as simply seeking to blame anybody else but him and his Government. Everything else is to blame: the pandemic, flu and unexpected pressures.
I am afraid that the Government are complacent. They are in charge of the system. I am appalled by the Secretary of State’s indifference. I actually find it quite shocking, because one cannot fix a problem if one does not accept that it is serious, that it is one’s responsibility to do so and that hard, hard work is necessary to get these things right. I am afraid that what we have from the Government is complete indifference and complacency, and I am very sorry to say that it comes across as a lack of care.

Several hon. Members: rose—

Nigel Evans: Order. The next two speakers, Sir John Redwood and Mike Amesbury, are on five minutes and then we will go down to four minutes.

John Redwood: No one can deny that the health service is under extreme pressure. No one can look at it and not realise that there has been a big surge in extra demand, that there are problems from the hangover of covid when a large waiting list for less urgent treatments built up, and that we are short of doctors and nurses, not because Ministers will not authorise their appointment but because there are vacancies to be filled. As one of those who has been urging for some time to see a published workforce plan, I welcome the decision of Ministers to insist on that, and the sooner we get it the better. However, I am quite sure that there are a whole series of workforce plans already in the many dozens and hundreds of working trusts and quangos that constitute the NHS. It is about aggregating and making sense of those plans.

Dr Caroline Johnson: We often talk about the shortage of doctors. We know we cannot create a doctor overnight. It takes a substantial amount of time to train them. The Chancellor, a former Health Secretary, invested in five new medical schools to increase the number of doctors in training. Does my right hon. Friend agree that the Chancellor, with the Health Secretary, needs to invest more money in more medical schools and medical school places, but also look at how we increase the  number of doctors by reducing the amount of bureaucracy and paperwork they have to fill in, so that they can spend more time doctoring and less time filling in forms?

John Redwood: Yes, indeed. From my hon. Friend’s own expertise, I am sure she is right. When people talk about productivity, they do not believe that hard-pressed staff have to work harder; they are saying there must be smarter working, making jobs more manageable or enabling them to concentrate on the things they are most skilled at, with more relief for the other necessary record keeping, which may indeed need slimming.
My hon. Friend is right that we could expand our training places further, but as we have heard there has been a big increase in educational provision and it takes seven years for it to flow through. I am glad we are getting to the point where we will see some benefits from that. We need more homegrown talent. Many people are attracted to the privileged career of being a doctor and the more we can allow to do that, the better. However, given the immediate urgency of needing more capacity, and therefore more doctors and nurses, the most obvious place is to look at all those who have already had the training and have left the profession or the NHS for one reason or another. Some may be in early retirement. That is probably not something my hon. Friend wants to change because she enjoys her new job, but there are many others who are not in a very important job like her who might be attracted back. I hope the Treasury will be engaged in the review, because I hear from doctors, as many do, that the quirk in the tax system at just over £100,000 where some of the better paid doctors are resting, producing a more penal 60% rate, is an impediment to extra working. I also hear about the pension problems that have been cited on both sides of the House. The Government need to take those issues more seriously if they wish to accelerate returns.
Ministers have very clearly set out that they want more NHS staff and have obtained much larger budgets in the last three years to help bring that about. They have also said very clearly that the public’s priority—and indeed the Opposition’s priority—is to get more treatments and get those waiting lists and waiting times down for those needing more urgent or emergency care. Those Ministers must translate that through the senior health service managers into ways of spending that extra money. If it needs a bit more extra money, there is always some extra available—every time we meet another additional sum is announced—but it has to be well spent. It has to be spent on motivating and recruiting the medical workforce.

Aaron Bell: Will my right hon. Friend give way?

John Redwood: I had better not, because we are very short of time for colleagues.
The money has to be well spent and I hope that senior managers, as they give us a published workforce plan, will share more of their thinking. It is not good at the moment that there is such a breakdown in relations with talented and important staff in the health service. There is a complex system of pay reviews, increments, promotions and gradings of activities. All those things have flexibility within them. I look to the senior managers  on six-figure salaries to take their responsibilities seriously and get the workforce back on side, using those flexibilities within the system, because we deeply need them to be.
We need more supply because there is excess demand, for understandable reasons. Huge sums of money were tipped into the system to deal with covid. Not all of it was well spent, but that was understandable given the unknown nature of the beast at the beginning, and the obvious pressures in this place and elsewhere to get instant results with personal protective equipment, testing and so forth. That is now behind us, but unfortunately it disrupted normal hospital work and normal GP work and created backlogs.
I urge the Government to understand that part of the answer is having more bed spaces in hospitals, with the staff to back them up. I do not know why so many senior health executives never want to admit that. They always say that there are lots of bottlenecks and other issues. Yes, of course we need to move people on from hospital as soon as it is safe to do so, and of course we need more capacity in social care, but I say to Ministers that it would be great to have a bit more capacity in the main hospitals to give us extra flexibility and take some of the pressure off. Could not some of the extra £20 billion, £30 billion, £40 billion or £50 billion that has been found in recent years be spent on the combination of physical capacity and the staff to support it that we so need?

Mike Amesbury: I start, as many hon. Members have done, by thanking our NHS and social care staff. They go above and beyond every day and have sacrificed so much, especially over the past few years. However, it is no secret that they are struggling to cope. In fact, the NHS is not only on its knees but on its face, as the shadow Secretary of State has said in his recent powerful contributions in this place.
The NHS is facing the worst crisis in its history. Urgent action is needed to make our beloved health system work again, but the Government have failed yet again. They are failing millions of patients and NHS staff across the country, as has been evident from all the contributions to this debate—even those from Government Members who have championed the cause of their constituents. Waiting lists are out of control, staff are burned out and people are literally losing their lives, despite some of the denials from the Government Benches. Look at the stats published today by the Office for National Statistics: 50,000 additional people lost their lives last year. It is shameful.
Nationally, 7.1 million people are waiting months and even years for treatment. Mid Cheshire Hospitals NHS Foundation Trust serves the Northwich part of my constituency; more than 33,000 of its patients were waiting for care in October. Just 59% are seen within 18 weeks, which is well short of the NHS target of 92%. I have been told by people working on the frontline and certainly by my constituents that many of them are waiting, not only at A&E but in corridors and car parks, for hours on end—12 hours in some cases. I will take the House on a bit of a journey to Warrington and Halton, and then we will go on to the Countess of Chester and to Whiston, where it is the same. People are waiting 20 hours—it is simply unacceptable. People’s lives are on the line, and that is a direct result of 13 years of Tory mismanagement. It is nothing new.

Sarah Atherton: rose—

Mike Amesbury: I will not give way. We do not have much time.
We have heard about covid and about flu. Those are facts, but let us take a journey through history to 2010, when waiting lists were substantially lower. In March 2020, when this shower of a Government were in place, the figure was more than 4 million. Now it is 7.1 million. It is shameful.
We must remember that these are not just statistics; these are real people. My constituent Tracey from Runcorn contacted me because her husband required life-saving surgery and it was postponed, as has happened for many constituents who have been spoken about today. Jonpaul was sadly diagnosed with prostate cancer, and was told that the cancer was trying to break free from his prostate. Thankfully, following an intervention from my office, he was able to have his surgery owing to a cancellation, but in many of the stories we have heard in the Chamber today, that has not been the case.
It is not just patients who are suffering; hard-working, dedicated NHS staff simply cannot cope with the current pressures, and now—as the Royal College of Nursing says, for the “first time in history”—they have resorted to strike action, with a very heavy heart. The clapping is long forgotten, and now they are threatened with the sack. That is not just unacceptable but absolutely disgraceful, and any Conservative Members who vote for it should be ashamed of themselves. They are culpable.
As the shadow Secretary of State pointed out, we do have a plan. There is a great big pot of money available from non-doms. I know that the Prime Minister is rather keen on non-dom status—I am not sure what the interest is there—but that money could be used to create not only health but resources, the frontline resources that we need to get waiting lists down. I say to the Government, “Step aside: it is time for Labour. It is time to save and rebuild the NHS.”

Several hon. Members: rose—

Roger Gale: Order. I am afraid I have to drop the limit to four minutes, and it may be necessary to drop it down further to three minutes later. That depends entirely on colleagues, and how generous or otherwise they are to their friends.

Paul Bristow: When I heard the big announcement recently that Peterborough would have a new NHS community diagnostic centre, I described it in my local newspaper as a great Christmas present for our city. This is a good NHS news story. The new centre will include MRI, CT and ultrasound scanning, as well as phlebotomy and cardiology testing. I am so pleased about the benefits that the centre will bring: it will mean that more than 67,000 extra scans and tests can be conducted in Peterborough every year. Along with many other centres opening across the country, it will do just what the Prime Minister has pledged to do: cut NHS waiting times and detect conditions earlier. I am talking about it today because this is precisely what we need to do: we need to get on with the job and have a long-term plan for our NHS. I am delighted that Peterborough is getting this state-of-the-art facility, because it is fantastic news for my city.
Like the Prime Minister, I have huge admiration for NHS workers. Both my parents worked for the NHS as nurses for most of their lives, and I understand the sacrifice and the long hours that are involved. Let me tell a story about something that happened in my constituency only recently, which is an example of the amazing work of NHS staff. I was told this story by my constituent Ivelina Banyalieva.
On 31 December, at 8 pm, a new year’s eve Bulgarian party was taking place in a local restaurant. A guest at one of the tables started sweating and was asking for napkins to wipe his face. The next second, he was lying unconscious. Some of the guests picked him up and took him outside the restaurant. Some tried to help, but of course they did not know what to do. Using her first aid training, Ivelina was able to determine that the guest had swallowed his tongue, was not breathing and did not have a pulse. She was able to take his tongue back out and, along with one of the guests standing outside, she started cardiopulmonary resuscitation while restaurant staff rang 999.
After five minutes of CPR the first ambulance arrived, and its staff confirmed that the man was still not breathing and had no pulse. They immediately started defibrillation, and within two or three minutes two more ambulances arrived. For an hour and half, those staff fought for the man’s life. They took it in turns to give CPR as they became exhausted, but did not stop for a second. After those one and a half hours, they were able to detect a very weak pulse. They transferred the man to one of the ambulances, where they spent another hour putting him into an artificial coma, and then successfully transferred him to a Cambridge hospital. He was given surgery with the placing of three stents, and 12 hours later he woke up.
That story shows that amazing things are happening in our NHS in places such as Peterborough. Saving someone’s life—essentially, bringing someone back to life—is one of the most amazing things that anyone can do. Such stories give me great pride in our national health service. Getting a new diagnostic centre makes me incredibly excited for the future. Yes, the NHS is facing challenges—no one will deny that—but I look forward with confidence, given my experience as the son of two nurses and experiences such as the one I have described. I am confident that this Government’s long-term plan for the NHS will succeed. I am confident that it is the right plan for the people of Peterborough.

Toby Perkins: I rise to support the motion on behalf of not only the Labour party but every person in Chesterfield who has contacted me in recent times in despair about the state of our national health service.
I first came to this place in 2010. Over the first year or two that I was a Member of Parliament, I had virtually no casework about the health service. Very occasionally someone might have got in touch with me, but now in every single surgery, someone comes to see me about being unable to access a doctor’s appointment, or about how long they have been waiting for a hospital appointment or an operation. Tragically, far too often I meet the families of people who are deceased but would be alive today if they had got the treatment that they should have had. It is for them that we are having this debate. It is for them that we need a long-term plan.
One of my first duties in the new year was my regular monthly catch-up with Hal Spencer, the chief executive of the Chesterfield Royal Hospital. I was expecting it to be a difficult meeting, and my goodness it was. The strain put on the senior management in our national health service, due to the failures under this Government, was etched all over his face. Chesterfield Royal Hospital had a critical incident over the Christmas period. It is a very good hospital, staffed by wonderful people who are professional, committed and passionate about the service that they provide. But imagine being a caring, dedicated, passionate, committed person and meeting patients who have been waiting 24 hours on a trolley before you get to see them. Imagine being an A&E registrar and knowing that people are arriving in agony, but that all you can give them is paracetamol to get them through the next 12 or 18 hours before they are seen. Imagine being a professional and seeing people with cancer who have been waiting, knowing that their cancer has got worse because you have not been able to see them soon enough.
The constant sticking-plaster approach of this Government is letting those people down. It is, as the motion says, costing hundreds of lives every week due to the collapse of emergency care. As my hon. Friend the Member for Ilford North (Wes Streeting) said, we need that long-term plan to address the staffing crisis in our national health service, which has 160,000 vacancies. We need it to address the failure in general practice where the poorer you are, the more likely it is that your GP service will be unable to see you. We need it to address the failure in care that means 100 people in Chesterfield Royal Hospital over Christmas were fit to leave but did not have a care package to support them.
If we can get that long-term plan to address the failure in general practice and social care, we will save money. One of the maddest things about the failure in our NHS is that we are spending far, far more treating people in hospital beds than if we were able to treat them at home with a social care package, or in a general practice if they were able to get in there. I support the motion and I thank my hon. Friend for introducing it. The people of Chesterfield will demand that we deliver when we get a Labour Government.

Anna Firth: Time is short, so I want to put on the record straightaway my thanks to all the hard-working hospital and ambulance staff at Southend Hospital and everyone working in the NHS across the city of Southend and picturesque Leigh-on-Sea, because none of them is on strike and all of them are treating patients with huge care and dedication. They are also innovating at high speed to tackle the unprecedented demand on their services. Two modular ambulance units have already been installed at Southend Hospital, providing 12 extra beds; an enhanced discharge service pilot was started last year; an active discharge ward has been opened with 12 beds and 12 comfy chairs; and yesterday 12 major treatment spaces were added, with more to come. I know this because I am in regular contact with my hospital and the local NHS and I have been visiting the hospital and seeing and supporting what it is doing on a regular basis. It is very impressive and it deserves all of our praise and recognition.
That is not to say that my inbox is not also full of people’s problems with accessing the NHS, and of course there is more to do. However, we have to look at this in context. We have to look at the international context, because these challenges are not unique to the UK. Countries around the world are facing an unprecedented double whammy from the combined upswings of covid and flu leading to hospitalisations. France currently has 22,500 people in hospital with covid, and Italy has more than 8,000. When it comes to flu, cases in Italy have hit their highest level in 15 years. Even Sweden, always held up as a great exemplar for the NHS, has a huge burden on its healthcare systems due to respiratory viruses.
Obviously the UK is not immune to these twin pressures, and obviously we are facing much higher rates of hospital bed occupancy than is normal at this time of year. We have 8.6% of our beds occupied by covid patients. Four years ago, there were none. Last year there were only 50 people in hospital with flu. This year there are more than 5,000—a hundredfold increase. As I have said, in Southend we are seeing identical figures on a local level. However, to suggest that we are not committed to our NHS is frankly outrageous.
In addition to the billions of pounds—I will come on to funding in just a minute—we delivered 9 million flu shots and 7 million autumn boosters into people’s arms last year. This was to prepare for what we knew was coming. We are putting in an additional 7,000 beds, and £500 million into delayed discharge before Christmas and another £250 million now. Over the last 12 months we have recruited 4,700 new doctors and more than 10,500 new nurses. Of course there is more to do, but to suggest that nothing has been done—which is what one might think, sitting here and listening to Opposition Members—is plainly not true. We have heard the PM’s plan to tackle the backlogs and waiting lists. If they think that is not much of a plan, they should consider what the Nuffield Trust said last week about Labour’s plans. It said that they would
“cost a fortune and stem from a failure of understanding and an out-of-date view”.
Last week—[Interruption.]

Roger Gale: Order. The hon. Lady is out of time.

Kim Leadbeater: We are in the middle of the greatest NHS crisis for a generation. Hospital beds are full, hospital corridors are full, patients are waiting hours, even days, in ambulances outside A&E, GP and the dentist appointments are almost impossible to get, medicines are running out, waiting lists continue to grow, and doctors, nurses and care staff are exhausted. We all know this, and I think we also know where the blame lies. It lies at the door of the Government, not only for their inaction over the last few weeks and months, but for the years of mismanagement that have left the NHS under-resourced, underfunded and understaffed.
With the greatest of respect to Conservative Members, people in Batley and Spen and elsewhere are not interested in international comparisons; they are interested in solutions. After 13 years in power, the Conservatives have to take responsibility for the current crisis in the national health service. There is quite simply nowhere for them to hide, and I think they know it.
Every hon. Member has stories of constituents who have faced an absolute nightmare in recent weeks and months. I would be extremely surprised if Conservative Members have not received the same kinds of emails that every Labour Member receives every day about the current state of the NHS. I have a list of constituents, friends and family members who have not received the care they deserve due to the huge pressures within the system.
Of course we understand the impact of the pandemic, but the NHS would be in a far better position to cope with the demand it now faces if there had not been a lost decade, and more, of underfunding and staff shortages. The public and our incredible, tireless NHS staff are now paying the devastating price for this Government’s failings.
Last week I visited Cleckheaton group practice, a GP surgery in my constituency. I spoke at length with the practice manager about the pressures it is facing, its struggle to recruit and retain staff, the dramatic increase in case load, the increasing level of abuse and the real pain of not being resourced to provide the service that the practice wants to provide.
When patients ring for an appointment, receptionists desperately want to book them in to see a GP. They understand patients’ desperation, but the capacity is simply not there. The practice received 690 phone calls in just two hours. Staff are doing their very best, but they are struggling on a professional level and a human level. We often talk about the NHS as an organisation, as a thing, but we must never forget that it is full of real people who feel the daily impact of this crisis and longer-term Government mismanagement. The impact on their physical and mental health must not be ignored.
Where is the serious work needed to prevent the next crisis or to introduce longer-term preventative health measures to free up capacity in the years and decades to come? The Government have a role to play, but this type of forward thinking, solving problems before they arise, has been sorely lacking for the last 13 years. I am enormously reassured that, as a Government in waiting, we in the Labour party have begun that work, setting out the long-term plans and fixes our country needs. The next Labour Government will make the decisions needed to ensure that our country is fit for the next generation.
However, in the short term, I plead with the Government to treat the NHS crisis with the seriousness and leadership it needs, and to work collaboratively with healthcare staff and the unions. We all rely on the NHS being there in our time of need, and I know that I speak for many constituents who are deeply concerned that, if they become ill in the next few weeks, an ambulance will not be there for them, the hospital bed they need will not be free and the doctors and nurses will not be there to care for them. The Government are failing in their primary duty to keep us safe, and what we are seeing under their watch is simply not good enough. Our constituents deserve better, our NHS deserves better, and Britain needs and deserves better.

Luke Evans: As a parliamentary candidate, I was once asked by a journalist, “We have 30 seconds left on the panel. How would you solve  the NHS?” I said, “If I had that answer, I would not be sitting here with you.” Mr Deputy Speaker, you have given me four minutes to do it, and I will do my best.
My hon. Friend the Member for Erewash (Maggie Throup) made an important point about context, and it goes back to when the NHS was formed in the 1940s and 1950s. We have an ageing population. In the last two decades we have seen a 50% increase in the number of 100-year-olds. Many people over 70 have four, five or six medical conditions and are on multiple medications. Technology has moved far forward, too.
When I started training, a cholecystectomy to remove the gallbladder was open surgery that required a person to be in hospital for a week. It can now be done within 24 hours. When we started people on routine blood pressure medications such as ACE inhibitors—many Members will know ramipril—they had to stay in hospital to have their kidneys checked. We now start it routinely for millions of people across the country.
That is the pace at which we are moving in the west and the developed world, and we have to try to keep up. Throw in a pandemic and workforce shortages, and we can see why every western country with a developed care system is struggling. That is the backdrop of what we are dealing with.
On top of that, demand and supply have gone up, but they have not gone up equally. Services are working hard to provide more tests and more appointments than ever before, yet demand is growing partly because the pandemic led to later and more complex presentations. In the Health and Social Care Committee we have heard that there are 27.5 million GP appointments a month, which is up by 2 million on 2019, yet it is still not enough.
In my area of Leicestershire and Rutland, we have enough GP appointments for everyone to be seen seven times a year, but the problem is that appointment rates are disproportionate. Some young people never need to go, and many older people need routine follow-ups. This is the backdrop we are dealing with. Members on both sides of the House talk a lot about long-term plans, but I would like to focus on day-to-day stuff.

Aaron Bell: I am grateful to my hon. Friend for bringing us his experience from before he came into this place, and he is right to look at the long-term demographic challenges. Does he agree that they will require the NHS to become even more efficient and productive? That is not just something we are asking for; it is what the staff in the NHS want, because they are aware that they are still delivering analogue services in a digital age.

Luke Evans: My hon. Friend has hit the nail on the head, and that is where I want to focus my remarks, because simple day-to-day changes to make the working clinician’s life better in turn improve productivity, patient care and patient satisfaction.
As with the Sky cycling team, looking for percentage gains brings big outcomes. So let us go through a quick list of some things we could do. We could have a root-and-branch review of prescribing. How much time is spent with patients waiting for prescriptions in hospitals to be dispensed? How much time is wasted by GPs signing prescriptions on paper? We have electronic prescribing but the prescriptions still get printed out to  be signed. A root-and-branch review of prescribing all the way through would solve that problem, making this system more streamlined and fit for the 21st century. It would also save wastage, because there is an estimated £1 billion-worth of medication in Mr and Mrs Jones’s back cupboard just in case.
What about the IT? I am talking not about singing and dancing robots, but simply about making the IT for the day-to-day clinician work like their mobile phone does. That is not too much to ask. We could address the interface between primary and secondary care, allowing secondary care to be able to book blood tests into primary care and vice versa. This stuff does not happen. We no longer send faxes but we still send letters instead, and we pay someone to scan them so that a doctor can have a look at them and sign them off. We could cap list sizes, on a graded time for GPs. We are recruiting more GPs and it is going to take time, but that is a way of ensuring demand and at the same time continuity of care.
What about all the other stuff associated with the administrative time of looking after doctors to make sure they are fit for purpose? There is so much red tape when someone tries to join a performers list or come off one, or start an induction in a hospital. This is simple stuff we can change now, today. We can further do that by enabling the new ICBs, because my biggest worry with them is that they are going to ask for permission not for forgiveness. These 42 regional areas will be able to design the difference that can stick for the future.
I was hoping we might be able to spend these few hours today talking about the wider picture, because this all comes from context. The biggest question this House has to answer is what is the purpose of the NHS and what should it do? We all agree with the principles of clinical need and not to have to pay, but how do we deliver that for the 21st century?

Several hon. Members: rose—

Roger Gale: Order. I regret to say that I must now take the time limit down to three minutes. I am desperately trying to get everybody in, but we are trying to get a pint into a half-pint pot. I call Claudia Webbe.

Claudia Webbe: The first thing that needs to be said in this debate is that its title gives a false impression: “mismanagement” creates an impression that the Government have been doing their best to manage the NHS well but have failed to do so, whereas in fact the emergency in our NHS is the result of 13 years of deliberate policy decisions by the Conservatives. A staff shortage of 133,000 that has only grown in recent years is not “mismanagement”. A shortage of almost 40,000 NHS nurses is not “mismanagement”, especially not when the Government knew there was a huge shortfall and decided anyway to end the nurses’ bursary and make already-underpaid nurses pay a fortune to train while inflicting annual real-terms pay cuts on staff across the NHS.
Consistently allowing staffing numbers to remain far below safe levels is a decision, not something that was just badly managed, as was the intentional fragmentation  of the NHS and the Health Secretary’s decision, along with the Government in 2012, to end statutory responsibility to provide a safe and fit health service. Cutting thousands of beds and millions of annual bed days in the NHS is a wrecking strategy—even more clearly so when it continued during the pandemic. It is part of an ideological push towards a rationed system that is more profitable for private providers and in which the NHS is in perpetual crisis not because of demand, but because beds, staff, hospitals and services have been intentionally slashed below the demand that was there. Even the current push to a so-called “integrated care system” is acknowledged by the King’s Fund and others to be, in reality, based on a US accountable care system that is designed to withhold treatment in order to cut costs and share the profits with private providers.
It is vital to be clear that the NHS is not merely collapsing; it is in a state of induced coma. There is not enough time in this debate to properly list all the damage that Conservative Governments have done to our health service in the past 13 years—and all in the full knowledge of what the consequences would be for those who need the NHS and who work in it and the deaths that it would cause.
The scale of this intentional damage is so great that playing around the edges with a little more cash that will end up in private company accounts—let alone talk of one-off payments to NHS staff who now rely on food banks—is just PR. The solution to all this is not better management; the only solution to 13 years of fragmentation and hollowing out is a return to the NHS’s original principles: a publicly owned, properly funded national healthcare service free to all.

Roger Gale: Order. I must ask hon. Members to keep one eye on the clock. I know that it is difficult when you are reading notes, but you really must watch the clock.

Nicholas Fletcher: We have heard much negativity from the Opposition, which I need to address. First, I wish to thank all the nurses at Doncaster Royal Infirmary who did not go on strike. I hope the doctors will follow suit. Secondly, I wish to read out this redacted letter from one of my constituents:
“Dear Sir,
I recently had occasion to consult my doctor over an ongoing medical condition. The GP who examined me was courteous, clear and informative and referred me to Doncaster Royal Infirmary. I expected a long wait to be seen, but within a week I was asked to visit DRI. Again, expecting a long wait, I was surprised to be attended to by the consultant straight away. He was good humoured, explanatory and took the time to explain the condition. The following week, I received the results of the examination I had undergone.
At a time when the news is dominated by the failings of the NHS, I have to state that I found my treatment of the very best and my GP, the consultant and the staff at DRI deserve the greatest praise for their outstanding work.
I do hope that you will convey my appreciation to those concerned.”
I know that not everybody receives that kind of service, but let us give credit where credit is due. Perhaps the Minister will reward Doncaster staff by giving them a new hospital—I just thought I would get that in there.
We all know that many of the issues that we face are down to covid, but I am hopeful that, with the introduction of the integrated care boards, the additional staff and the additional funds to help with bed blocking, we can achieve the goals that our Prime Minister has stated and that soon all our constituents will receive the service that they deserve.
While I have the opportunity, I wish to take a few seconds to thank Anthony Fitzgerald and Richard Parker, who both work tirelessly in the health sector in Doncaster. Their work is unsurpassed by anybody else I know. I want to say one thing to the unions. We understand that this is a tough time, but these strikes will not help. The best thing that they can do is work with everybody—work with staff, work with MPs, and work with the NHS as an employer. Let us all come together and put the NHS where it needs to be and the country where it needs to be—the pride of Europe. Let us all get back to work and let us start doing that now.

Charlotte Nichols: Thirteen years of Conservative Government have led to crises in every part of our health and social care system. Our infrastructure is breaking down, patient experience is at rock bottom and the consequences of the mismanagement of our health staff is all too clear. Of course covid has played a part, but most of those things were dangerously clear before the pandemic struck. Up and down the country, the condition of repair of our hospitals is declining. Despite all the bluster of the former Prime Minister and his successors, in Warrington, we are still waiting for a decision on a new hospital—if the Minister wants to announce it today, we will be very grateful. We just do not have the capacity to deal with the number of people requiring care in a town our size with the dated, far too small hospital that we have, despite the best efforts of our incredible staff.
In June last year, ITV’s “Tonight” spent a couple of days filming with the North West Ambulance Service and Warrington Hospital. It reported horrific conditions, with patients forced to sleep on trolleys for days on end outside A&E departments, and that was back in the summer. Since then, we have only seen matters get worse. Over the winter, I have heard horror story after horror story from constituents, and I will read just one: “My dad, aged 72, arrived at Warrington Hospital on Christmas morning by ambulance after being unable to walk and being confused at around 3 am. I was shocked to see a number of trolleys with patients winding around in the corridor in the A&E department, with paramedics attending to patients and nurses rushed off their feet treating multiple patients. He was in a trolley in the corridor for 26 hours before being admitted and kept trying to get off the trolley, as he was very distressed and confused. I spent three days going in and out of the hospitals and walking through the corridors and A&E department and I honestly feel traumatised by the experience.”
Those failures are unprecedented and a total collapse from the achievements that the last Labour Government left. It is all too easy to make a debate such as this about statistics, but the reality is unnecessary pain, distress and death. When Nye Bevan wrote “In Place of Fear”,  he proposed a healthcare system that would remove the anxiety of illness and injury and make us a more secure, contented and productive society. This Government have overseen the return of fear. The degradation of our national health service since 2010 is a national tragedy, and I warn Government Members that, if they do not address it seriously, that will be their shameful legacy.

Simon Baynes: I am not particularly surprised by the absence of Labour Welsh MPs from the Opposition Benches, because they have a health service with inferior outcomes compared with England. There has been a lot of talk about 13 years of Conservative Government, but in Wales it is almost double that, at 25 years of Labour Government, yet we have poorer outcomes.
There are many statistics, so I will focus on one. In terms of waiting more than 52 weeks, figures are worse in Wales, at one in four, compared with one in 20 in England. That sums up the problem that we have. If the plan of the hon. Member for Ilford North (Wes Streeting) is so great, why do the Welsh Government not implement it? They are in power and capable of doing so.
The hon. Member for Wallasey (Dame Angela Eagle), who is no longer in her place, talked at length about the issues of the strikes by healthcare workers in England, but exactly the same situation exists in Wales, and the attitude of the First Minister in Wales is very similar to the attitude of the Government here in dealing with those strikes. Yet again, we have a situation where the Opposition Members are not admitting that the problems in Wales reflect the fact that their Government are ensuring poor performance.
Of course, in my Clwyd South constituency, those are not dry statistics, but the day-to-day problems that people face: problems in getting to see a GP or receiving timely hospital treatment, as well as with often excessively long ambulance waiting times. Mine is a border constituency. We look across the border to see what is going on in England and share healthcare across the border, so the comparison between Wales and England is all the more acute.
My right hon. Friend the Member for Vale of Glamorgan (Alun Cairns) spoke about the fact that the Welsh health service’s level of funding is superior to that of England. He also mentioned the cut of £800 million in 2012 by the Labour Government in Wales—the only Government in Britain to cut NHS spending in modern times—which has meant that, while the increase in health spending in England since 2010-11 has been 29%, it has been inferior in Wales, at only 22.6%. In conclusion, I urge the Labour Opposition to focus on improving their stewardship in Wales.

Afzal Khan: I would like to begin by placing on record my personal thanks to the thousands of NHS staff across Manchester: nurses, doctors, paramedics, healthcare assistants and sports staff. I remain grateful for the care they showed my mother and both my parents-in-law in their last days at the height of the covid-19 pandemic. I am proud that so many members of my own family have chosen to dedicate  their working lives to the NHS. They deserve not empty platitudes but respect. These are not crises of their own making.
This disaster is the direct result of decisions made by Government over the last 13 years. Nearly 10% of the UK’s population is on the NHS waiting list, and there are three times as many patients on NHS waiting lists as there were 13 years ago. In November, 37,000 waited more than 12 hours to be seen in accident and emergency departments across the country. When Labour was in power, it was just one hour.
Over the last few weeks, the NHS in Greater Manchester has experienced some of its busiest days ever. Over 98% of beds in our hospitals are occupied. Thankfully, we have not faced critical incidents in Manchester’s hospitals. That is in no small part thanks to the hard work of local clinicians and staff, and because the devolution of NHS decision making to Greater Manchester allows greater flexibility and collaboration between hospitals, primary care structures, local councils and the combined authorities. That reflects the findings of the Griffiths report—it marks its 40th anniversary this year—which found not only that effective management is the backbone of a high-quality health system, but that there must be devolution of power from the political centre to the operational frontline.
We cannot fix the crisis in the NHS without fixing the crisis in social care. There are 165,000 vacancies in social care. Carers leave the profession every day because they can get a better deal working in a supermarket than they can working in care. Despite the crisis, the Government still have no plan. The truth is that our NHS heroes and their patients have been let down by the Prime Minister, the Secretary of State and their predecessors. Members on the Government Benches know it, too. After 13 years of Tory failures, only the Labour party now has a plan to fix our NHS.

Aaron Bell: In line with the wording of the amendment, which I rise to support, I thank all NHS staff, particularly those in Newcastle-under-Lyme and in north Staffordshire at the Royal Stoke University Hospital, which, as the Secretary of State acknowledged both on Monday and today, has been under the severe pressures we have seen throughout the health service over the last month. As he acknowledged, many people have had unacceptable experiences. I have seen examples of that in my inbox and I have fought for my constituents in those cases.
I also thank the local leadership, the integrated care board and, in particular, Tracy Bullock, the chief executive of the University Hospitals of North Midlands NHS Trust, for their time in briefing MPs about what has been going on. We have suffered the fourth highest level of flu in the United Kingdom at the Royal Stoke; it is the fourth worst-hit trust. We were running up to 30 flu admissions per day in December. I am pleased to say that that is now back down to a more normal level; it is about 10% of that. Of course, a lot of those flu admissions were people aged 85-plus who needed critical care.
As I said in an intervention, there is absolutely no acknowledgment of covid in the Opposition’s motion, despite the fact that there are still covid cases in hospitals and the backlog has had an effect on all our NHS services. That needs to be acknowledged.
To say a little more about the Royal Stoke, we are pleased that a new ward of 28 beds will be open next week thanks to Government investment last year. I know that Tracy will want me to request from the Minister even more capacity for next winter. The Royal Stoke is still in a very difficult position because of Labour’s private finance initiative—it is one of the most indebted hospitals in the country. That has been raised with multiple Secretaries of State. I know that it is an expensive thing to sort out because Labour wasted so much money on PFI, but we need to address it.
The Government have a long-term plan, as many on the Conservative Benches have said. It is about doctors and nurses and more GP appointments. We have record numbers of people in training as undergraduates and on nursing and midwifery courses. It is also about the long-term strategy, new surgical hubs, community diagnostic centres—my hon. Friend the Member for Peterborough (Paul Bristow) talked about his one—and our elected recovery taskforce, putting more spare capacity in the independent sector to use.
We know about elective recovery because we had to recover in 2010, when we inherited 20,000 people waiting more than a year for elective surgery. We got that down before the pandemic to under 1,000. Forgive me if I say that all the lectures from Opposition Members about how marvellous things were under the Labour Government ring a little bit hollow, especially as a Staffordshire MP. We experienced the absolute scandal of Mid Staffs under the previous Labour Government. I applaud the work that the current Chancellor, the former Health Secretary, did to get avoidable deaths down. That did not happen under the previous Labour Government.
I am very short of time, but I commend in particular the speech of my hon. Friend the Member for Bosworth (Dr Evans) who brought his experience to bear. There is so much that needs to be achieved through productivity and innovation in the NHS, and that is how we will get a long-term NHS fit for the future.

Taiwo Owatemi: Today I would like to cover two matters that are deeply important to my constituents and where the Government have consistently failed to show vision or leadership and have left the country in a state of emergency.
The first is the issue of pharmacies and GP waiting times. As a pharmacist and the newly elected chair of the all-party parliamentary pharmacy group, I urge the Government to look again at utilising the key resource of community pharmacy. The sector is crying out for more responsibility to reduce pressures on the rest of the health service. Community pharmacists must become the first port of call for patients who need advice and treatment, as they are in almost every other European country. That will help to rebalance workload across primary care, bring healthcare back into the community, reduce pressures on GPs and waiting times and deliver healthcare that is much more prevention-focused.
Yesterday, I launched a survey for my constituents on the situation in our NHS, and I quickly received more than 200 responses by this morning. I was appalled that 70% of my constituents told me that they were putting off dealing with health worries because of the terrible situation in the NHS. That is incredibly dangerous, and  it is exactly why we have to empower community pharmacies and reduce GP waiting times. Until the Government fully mobilise pharmacies, we will struggle to reduce waiting times, clear the NHS backlog or improve patient access to GPs.
Secondly, I will speak about the ongoing ambulance crisis that is having a disastrous impact on many of my constituents. Ambulance drivers in Coventry tell me that they are unable to support their families, that they are overworked, underpaid and that extra support is simply not available. My constituents are frequently having to wait hours on end for an ambulance to arrive during an emergency. This is all because the Government have failed in their duty to demonstrate leadership.
In my survey of constituents conducted just this week, one in five told me that either they or a family member had suffered delays when waiting for an ambulance in the past six months. One older constituent had to wait 10 and a half hours for an ambulance to take him to A&E after having a bad fall over the Christmas period. That is simply unacceptable, and it is putting people’s lives needlessly at risk. Lastly, I thank all the NHS staff at my local hospital, University Hospital Coventry and Warwickshire, for all their dedication and hard work and everything they do to provide excellent patient care.

Mohammad Yasin: Bedford Hospital, its partners in the Bedfordshire, Luton and Milton Keynes trust and ambulance services are currently experiencing an extreme level of pressure, with record numbers of people using services. The NHS is trying to cope with this level of demand with record waiting lists and a depleted and burnt-out workforce. Desperate times call for desperate measures, which is no doubt why The Sunday Times recently reported that Bedfordshire patients could find themselves being treated in field hospitals. Although the trust board said that the use of field hospitals was not imminent, the fact that it is being discussed at all should worry the Government. The Prime Minister and other Ministers will not even admit that there is a crisis. If they did, perhaps they would take some meaningful action.
The latest Care Quality Commission inspection report on Bedfordshire Hospitals NHS Foundation Trust in December found an overall rating of good, which is testament to the hard work of staff and hospital leaders. However, the trust was found to require improvements around safety, particularly in relation to urgent and emergency care, medicine and maternity services. Much of the concern relates to waiting times and staff not having completed training in line with the levels required for their role. Workforce shortages are at the heart of these problems. If staff are unable to take the time to complete training or are spread too thinly to do their jobs properly, it is inevitable that the service they are able to provide will not be as it should. Staff and patients deserve better.
The most pressing issue in Bedford is the serious delays in funding for capital expenditure. The primary care estate is not fit for purpose and is a threat to patient care and the ability to attract GPs to the area.
Despite six years of waiting, the Government are still stalling on their promise to return in-patient mental health beds to Bedford. More children are seeking mental health support than ever before. Plans and funding are in place for a new mental health facility with specialist places for children, yet the East London NHS Foundation Trust is still waiting to hear from the DHSC if its expression of interest in the new hospitals programme, announced a year and a half ago, has been successful.
The Conservatives have been in power for 13 years. It is clear that the NHS has been broken apart piece by piece, despite the best efforts of staff. To go from record NHS satisfaction levels under a Labour Government to patients dying waiting in A&E under this Government is a dereliction of duty and a shame on our nation.

Several hon. Members: rose—

Roger Gale: Order. This is a test of your ingenuity—whether you can sell a bar of soap in 30 seconds—because you are going to have to go down to two minutes if I am going to get everybody in. Do your best. I call Robin Millar.

Robin Millar: I acknowledge the hard-working staff of Betsi Cadwaladr University Health Board, who serve us to the best of their ability and make terrific efforts to give us the care that we need and deserve in north Wales.
I want to mention Welsh colleagues from across the House, many of whom share my concern over the state of the health service in Wales. I know that some who are not present today will share that concern, even on the Opposition Benches, although it does raise the question of why they are not present. My right hon. Friend the Member for Vale of Glamorgan (Alun Cairns) and my hon. Friend the Member for Clwyd South (Simon Baynes) make the case for Wales as a case study of healthcare under Labour. I add to their observations that healthcare spending now accounts for some 55% of the Welsh Government budget.
I want to look briefly at the effects of the Labour prescription for healthcare in Wales. Our treatable mortality rate is 20% higher than in England. Last year, five out of seven of our health boards were in some form of special measures. My health board, the Betsi Cadwaladr University Health Board, was in special measures for six years. It got so bad that the BBC reported on a patient from Swansea who was forced to go to Lithuania for a hip operation when she discovered that she was on year four of a seven-year waiting list for treatment. The hon. Member for Batley and Spen (Kim Leadbeater), who is not in her place, was absolutely correct when she said that the Government have to take responsibility—the Welsh Government must take responsibility for their 25 years of stewardship of healthcare in Wales.
On the defence of the hon. Member for Ilford North (Wes Streeting) for the inequalities in Wales, I would say this: in 2015, the Nuffield Trust reported that the Welsh Government had used their powers to set different priorities and a different tone from their London counterpart. It has emphasised prevention—

Roger Gale: Order. I call Paulette Hamilton.

Paulette Hamilton: I was a nurse for 25 years and I returned to the frontline during the pandemic. I know at first hand that after 13 years of Tory mismanagement, our NHS is in crisis. Many health workers who have dedicated their lives to caring for others day in, day out are still living with the after effects of having worked flat out during and before the pandemic, all while trying to do the work of three or four people due to staff shortages. It is soul destroying for people to go on duty knowing that there will be inadequate staffing levels for nine or 12-hour shifts. Tory cuts have reduced A&E departments to shells of what they were under the last Labour Government—they are now so busy that staff feel that they can seem, at times, like a zoo.
Social care needs fundamental reform that truly brings together health and social care. People in Erdington, Kingstanding, Castle Vale and across the UK are finding it almost impossible to get a GP appointment, an ambulance or an operation when they need one, but the implications of stress on the health of staff can be tragic. The ongoing failure of the Government to address staffing levels can be a matter of life or death for patients. It breaks my heart to say that I just could not face the prospect of working in nursing right now.
In November, 140,000 people had to wait more than four hours to be admitted to A&E, and unfortunately my husband was one of them. If we add all that time together, collectively, the British public waited almost 65 years for emergency treatment, but the real question is: how much longer will they have to wait for a competent Government—

Roger Gale: Order. I know this is difficult, but we have to keep to the time. We will now not get everybody in.

Danny Kruger: I put on record my appreciation and thanks for the NHS staff who serve my constituents in Devizes in Wiltshire, particularly those at the Great Western Hospital in Swindon and the Salisbury District Hospital, our local doctors and pharmacists, and care workers.
I accept the reasons that the Secretary of State gave earlier for the pressures that the NHS is under, which are largely immediate and covid-related. There was a recent policy that led to many of those problems, of which Labour was the principal cheerleader, and we are now seeing the reckoning of those lockdowns. It is no surprise that we have 10 times the usual number of flu admissions to hospital and double the number of delayed discharges.
It is also true, however, that there were problems in the NHS before covid. Although we talk about the crisis in the NHS, it is a perennial crisis. When we are in Government, Labour Members talk about the crisis in the NHS, but when they are in Government, we talk about the crisis in the NHS. There has been a significant crisis throughout the history of the NHS.
The shadow Secretary of State is right to say that we need fundamental reform, but I am not sure that that is what we are hearing from him. He listed a lot of outputs that he wants to achieve, such as more staff, and a whole bunch of inputs, such as more money from the inexhaustible  pot of non-dom taxation. More important than spending and inputs, however, is the value for money that the NHS needs to generate, and we have not heard a proper plan to change the systems to achieve those improvements.
The Government have a plan, which is the integration of health and social care. I support that integration and localisation. We should go further and integrate the non-specialist services that exist in our communities. Much of the demand on health and social care is driven by lifestyle and relationships, so we need to harness the immense resources of civil society to support families and communities. I end by paying tribute to the social prescribing project that the Government have introduced, which is achieving such good results.

Janet Daby: Our NHS is in crisis, and it must never be overlooked that it was in crisis before the pandemic. The British Medical Association has supported that view and said:
“Demand for hospital treatment was outstripping capacity even before the pandemic. In recent years, patients have been waiting longer for emergency, routine and cancer treatment.”
It is clear that our national health service is not safe under this Government, because our ambulance service is in crisis; our A&E departments are at breaking point and in crisis; operations are being delayed and cancelled; there are long waiting lists to see consultants and GPs; and patients cannot be discharged. The Government are failing to overcome the challenges that the health service has faced since we left the EU, especially in terms of the NHS workforce and medicines. Staff are experiencing burnout and NHS hospitals are understaffed. The NHS is in crisis.
As ambulance staff go on strike today, the Government must remember that people go on strike only because they are experiencing hardship—nobody takes the decision lightly. The Government should feel ashamed and disgraced that nurses have had to go on strike for the first time in their history. NHS workers in my constituency have said that, because of their current rate of pay, they have been forced to sell their car and they are thinking of leaving the NHS altogether. The health service has been run into the ground for both patients and staff. The Conservative Government must fix these systemic problems and end this crisis. If they do not, it will inevitably be left to a Labour Government to clean up this mess when we do get into government.

Rebecca Long-Bailey: A Salford health worker said to me recently:
“We visited a seriously ill man who was frightened of being taken to hospital and made it clear he was at risk of death and that he needed urgent treatment. He and his wife told us that when he was in last, he was left on a corridor for hours, he was not offered food, he is diabetic and could have died.”
He had waited hours. They went on:
“I found it heart breaking that this man would rather die than put himself in that situation again as he could not face the way he had been treated.”
Our constituents are frightened, and many are choosing not even to attempt to access vital treatment for fear of what will happen to them. Our health workers’ mental and physical health is deteriorating with the stress and pressures they are facing.
Of course, the Government claim they have given the NHS the funding it needs, but this just is not true. Of the half a billion pounds of so-called early discharge funding announced by the Prime Minster recently, only £200 million—40%—has actually made it to the NHS and local authorities. The BBC reports that, to help the health service cope with winter demand as well as pay for advances in medicine, the NHS budget has traditionally risen by an average of 4%, but since 2010—since this Government have been in charge—the average annual rate of increase has been half that. The King’s Fund calls this a “decade of neglect”, and it is right.
This Government are destroying our NHS. They are destroying our constituents’ faith in our NHS, and now they are destroying the very workforce who try to hold it together. The Government can solve this crisis: they can fund the NHS, scrap the Strikes (Minimum Service Levels) Bill and actually listen to our NHS key workers when they ring this alarm.

Karin Smyth: The root cause of this problem is capacity. In my area of Bristol, north Somerset and south Gloucestershire, we are short of roughly 300 beds. Commitments made in the 2004 plan, when we rightly closed one hospital and consolidated services in another, have not delivered community-based beds—mainly in south Gloucestershire, which is largely represented by Conservative MPs who do not want to admit that problem. Added to the low base of funding, in a growing city we have a real capacity problem, and the solution now is 30 temporary hotel beds. That will not cut it. It is short term and, frankly, a very poor use of money.
In the short time I have, I want to highlight some issues with the social care promise. We were promised so much, and people were led up the garden path. A lot of money has been allocated and, frankly, it has just disappeared. Some £3.6 billion was allocated for the social care charging system between 2022 and 2025. That has now been postponed. There was over £70 million for local authorities to look at market-shaping and commissioning capabilities—gone. As I said earlier, there was £2.9 million on trailblazers, but what have we learned from them, and how is that being used?
I have asked a lot of questions about where our money has been allocated, where has it gone and what we have got for it. In written answers, I have been told that we might get something on trailblazers soon—that was in October 2022—but in December, the Minister who is in her place said there were “no current plans” to publish an independent assessment of the fair funding trials by selected local authorities. It is our taxpayers’ money, but it has now been wasted and we need to know what has happened to it.
In conclusion, matching capacity to demand in all ICB areas, so that we understand in our own patches what is really happening, is the way forward. To help the system, we need to start paying carers a decent wage, with a career structure and decent employment rights, to reduce the 165,000 vacancies. That would give people the care they need where they need it, it would help women in communities increase their economic power, and it would rebuild primary and community-based services from the cradle to the grave.

Holly Lynch: I want to start by sharing the experiences of my own office manager. He has two children who are one and four. They both became increasingly unwell on a weekend. They had temperatures just below 40°C and were becoming lethargic, with the four-year-old complaining of a sore throat and the younger having spots on her tongue.
Concerned as all parents are about the tragic fatal cases of children with strep A, and with the GP closed, they decided to call 111. They waited one and a half hours for someone to answer the call, and were told that the symptoms were such that they required a call back from a GP within six hours. Shortly after ending the call, my office manager received a text:
“Dear Parent/Guardian, due to unprecedented numbers of calls, we are unable to provide a call back at this time, and your case has been closed.”
As the children’s condition worsened, into the evening and on a weekend, the parents became increasingly concerned for their children and felt that they had no choice other than to take them to A&E. After an eight-hour wait in A&E, into the early hours, an exhausted doctor came to the waiting room and told patients that he was incredibly sorry but there was no way they could see everyone, and that anyone who could possibly leave should do so. My office manager was faced with the decision reluctantly to take his children home.
In his speech to the nation, the Prime Minister asked people to judge him on his results, saying,
“judge us on the effort we put in and the results we achieve.”
He is not seeking to be in government; he is the Prime Minister from a party that has been in government for 13 years. We are judging him by the results. During his interview at the weekend, he repeatedly refused to say whether he uses private healthcare, insisting it is not really relevant. I know he clarified that point at Prime Minister’s questions today, but the Government’s response to the crisis so far has not reflected the sheer panic and hopelessness that people, and parents in particular, feel if their loved ones and children are seriously unwell, and the NHS is so broken that they cannot get any help.

Mary Foy: Let us be clear: the NHS crisis did not begin with covid. It is the culmination of 13 years of failure and neglect by the Conservative party. Nye Bevan described the creation of the NHS as
“the most civilised step any country has ever taken”.
After hearing the horrifying testimonies today of delayed ambulances and operations, it is clear that we have taken a giant and shameful step backwards. Our overworked and underpaid healthcare staff are telling us that with more than 100,000 vacancies in the NHS, safe and timely care can no longer be guaranteed. Underfunding is causing delays, and delays have real-life consequences on people’s lives, as I know only too well.
In 1989, a decade into an earlier Conservative Administration, my daughter was born 10 weeks premature. She needed a ventilator before she could breathe on her own. The local hospital did not have one, and neither did any of the surrounding hospitals. Eventually, one was found 30 miles away, and Maria was born three hours  later by emergency C-section. As a consequence she suffered brain damage, and lived her life with severe cerebral palsy. No parent should face such an agonising delay today, but the harsh reality is that there are no guarantees.
Decisions made in this place have life-changing impacts on the people we represent, and under the watch of the Tories, the words “NHS” and “crisis” have again become synonymous. Today, ambulance workers from the Unison and GMB unions have been forced to strike in order to protest against the underfunding of the service, and the dangerous disfunction it has created. People are dying needlessly. Labour has a clear plan to train a new generation of doctors, nurses and midwives, and to have meaningful negotiations to end the strikes.

Grahame Morris: In the time available I will focus, laser-like, on the issue I wish to raise, which is the mismanagement of cancer care. I declare my interest as vice-chair of the all-party groups on cancer and for radiotherapy. Covid has undoubtedly compounded the pressures on our NHS, but the problems in areas such as cancer care predate the pandemic—there is no doubt about that. Radiotherapy is a vital treatment option, which already plays a part in the treatment of about four out of every 10 cancers. It is highly cost-effective—a cure typically costs between £3,000 and £7,000—but its potential is being systematically overlooked, and there has been chronic underinvestment.
Ten months ago, the previous Secretary of State for Health and Social Care declared war on cancer, but we are still waiting for the weapons to fight that war effectively. We urgently need to improve treatment capacity in radiotherapy. As I have stated, a fifth of all radiotherapy machines are more than 10 years old and will need replacing before the end of the year.
We need a better approach to funding IT, technology and networking, as that could dramatically speed up treatment processes. New immunotherapy cancer treatments often work far better in combination with radiotherapy. I ask the Minister to commit to engaging with the all-party parliamentary group for radiotherapy and with leading clinicians to develop the potential of advanced radiotherapy treatment capacity and to bring about a step change in cancer outcomes.

Margaret Greenwood: Matthew Taylor, the chief executive of the NHS Confederation, has said:
“This crisis has been a decade or more in the making and we are now paying the high price for years of inaction and managed decline.”
He is right. The crisis has not emerged overnight. It was evident before covid, and it is a crisis of the Conservative Government’s own making.
That managed decline is a political choice. One needs to look only at the Health and Social Care Act 2012 to see the sheer ruthlessness of the Conservative party’s determination to run down the national health service. In that Act, the Conservatives and the Liberal Democrats legislated to allow NHS hospitals to generate up to 49% of their income from private patients. By 2015-16, nearly £600 million a year was being generated by the NHS treating private patients. How many operations  for the general public have been delayed while private patients were treated? How much shorter would those waiting lists be had those resources not been siphoned off to private patients? Why did the Conservatives and Liberal Democrats think it was acceptable to hand over about half of our hospital resources to private patients? To argue that it is about making money for the NHS is a sleight of hand; it is taking resources and capacity away from the NHS and it is morally indefensible. The NHS belongs to all of us; it is not the Conservative party’s to give away.
I have met people who, in desperation and pain, have paid for treatment and been angry at being put in the position where they felt the need to do so, not just because it is expensive but because they believe in the NHS as a public service. It felt terrible to them to be put in that position. The Government have chosen to reduce capacity in the NHS by handing it over to private patients, and they have failed to provide the staffing and resources that the service needs.
We need to reinstate the NHS as a comprehensive and universal service, publicly run and free at the point of need. It has served us incredibly well for well over 70 years. The public will not forgive those who undermine it so ruthlessly and cause so much suffering for patients and staff.

Fleur Anderson: I am worried and angry about the complacency that I have seen from the Secretary of State towards the NHS. Look, I knew that the situation was bad, but I did not realise how bad until I visited St George’s A&E last week. That hospital, which serves my constituency, had to declare a critical incident because of the situation in its A&E. All the doctors and nurses I spoke to agreed that it was the worst time that they had experienced in their whole careers. The winter ward was opened last year but had to stay open for the whole year, so there is no more space for the extra winter surge. Sixty nurses have resigned from that department because of the stress of the workload and being underpaid.
The additional winter payments that came from the Government were paid only in December and must be spent by March, giving them hardly any real impact. The situation is chaotic. The doctors and nurses are having to practise corridor care for patients for the first time in the hospital, and they are broken-hearted that they have to do so. They have had to stop elective heart surgery since the beginning of December. Mental health patients are being treated in A&E for five days. We need a long-term plan, not to be surprised by winter every year.
Four areas are seen as having critical community care shortages: eating disorders; Korsakoff dementia patients; frail patients who have a stroke after a fall; and functional neurological disorder. Those huge gaps in community care were raised by the staff. I am glad that the Secretary of State is in his place to hear me raise them.
The Conservatives are failing the people of Putney, Southfields and Roehampton. The Conservatives are failing the British people. Labour has a plan to fix this, but they do not. Pain, suffering and preventable deaths are up, GP waiting times are up, A&E waiting times are up, and mental health and cancer assessment times are up. There is only one conclusion: the Conservatives’ time is up.

Liz Kendall: Today’s debate has laid bare the dire state of our health and care system after 13 long years of this Conservative Government: more than 7 million people waiting for hospital treatment, 400,000 for more than a year; the worst ever waits for A&E, with 50,000 patients a week now waiting more than 12 hours in A&E; excess deaths this winter at their worst level since 1951, except for the pandemic years; ambulance response times plummeting; cancer targets missed; and waits for mental health care so bad that thousands of patients end up forced to go to A&E or even attempting to take their own lives. In social care, the situation is even worse: 165,000 staff vacancies, 30,000 more than in the NHS; more than half a million older and disabled people waiting to have their needs assessed in the first place, not even on a waiting list; and millions—millions—of families pushed to breaking point because they cannot get the help they need to look after their loved ones.
The question I want to focus on today is why we have ended up here. Labour Members have never claimed that everything was perfect in the NHS when Labour last left government, but Conservative Members squandered a golden inheritance of the lowest ever waiting lists and the highest ever patient satisfaction, with access to services we can only dream of now. Ministers want to blame all of the current crisis on covid and this year’s winter flu, but the truth is that waiting times were at record levels and staff shortages were soaring long before the pandemic struck.
The most glaring reason for the problems we face is the sheer incompetence of this Government. To take just one example, effective winter planning in the NHS is a non-negotiable and a key test for any Secretary of State. When Labour was in Government, winter plans were done and dusted well in advance. I know that from my time working in the Department of Health. So, it beggars belief that not a single penny of the original winter hospital discharge funding was out of the door by the end of November. Some £300 million of it still has not reached the frontline. Their latest flawed plan to buy up care home beds, when what most people need is care in the community or their own homes, was not even announced until 9 January. That is not effective planning; it is scrabbling to shut the stable door after the horse has bolted.
There are even more fundamental reasons for the current crisis than the Government’s sheer incompetence. The root cause is a decade of Conservative economic failure trapping Britain in a vicious cycle of low growth, low pay and high taxes, which in turn has failed to provide sufficient or sustainable funding for our public services, including decent pay for frontline staff. Einstein’s definition of madness was to keep doing the same thing over and over again but expecting a different result. Yet that is precisely what we saw in the Chancellor’s autumn statement, so Britain is once again set for, at best, anaemic growth by the end of the Parliament. Britain deserves so much better than this. Labour’s green prosperity plan, our industrial strategy and our plan to fix business rates set out a different path for the future. No wonder the chairman of Tesco says that in terms of a growth plan Labour is the
“only team on the field”.
Economic growth that delivers proper investment in the NHS and social care is vital, as Labour’s record in Government shows, but on its own it will not secure a care system fit for the modern world. It also requires reform. On that, Ministers have again utterly failed to deliver. Mr Deputy Speaker, you will forgive me if I take the House on a brief trip down memory lane. Remember the Lansley reforms? I am sure Conservative Members would rather forget. That legislation so large it could be seen from outer space, but no one understood what it was for. Years of time and effort were squandered on a disastrous internal NHS reorganisation that failed either to integrate care or to deliver the improvements in patient care that the Conservatives claimed. There was the Conservatives’ cap on care costs—[Interruption]—and their solemn promise that no one would have to sell their home to pay for their care. Remember that? [Interruption.] It was first promised in 2012, postponed in 2015 and 2017, and re-promised by the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) on the steps of Downing Street. [Interruption.]

Roger Gale: Order. It is perfectly plain that the hon. Lady does not want to give way.

Liz Kendall: Thank you, Mr Deputy Speaker.
The promise was buried once and for all by the Chancellor in his autumn statement last year—a Chancellor, I remind the House, who said that his biggest regret as Health Secretary was failing to put in place a long-term plan for social care.
In contrast—[Interruption.] I am sure the right hon. Member for Vale of Glamorgan (Alun Cairns) will be interested to hear this. In contrast, Labour has a 10-year plan for investment and reform in our NHS and social care. It includes the biggest ever expansion of the NHS workforce, funded by scrapping non-dom tax status; ensuring that patients can see the doctor they want in the manner they want, whether that is face to face, over the phone or online; a new deal for care workers—[Interruption.] Maybe the hon. Member for Ashfield (Lee Anderson) would like to listen to our plan and suggest it to his Ministers. We will have a new deal for care workers to tackle staff shortages and give older and disabled people the support they need. Above all, we will have a relentless focus on prevention and early intervention. There will be a new principle of home first, shifting the focus of care out of hospitals and into the community, with more people being cared for in their own home, which is where they want to be.
Using new technology, providing genuinely joined-up care and support, putting people first, giving staff the support they deserve, providing investment with fundamental reform: that is Labour’s plan, not the failed sticking-plaster approach that we have seen from the Conservatives over the past decade. Britain deserves a fresh start. We deserve a better future. That is what Labour will deliver. I commend the motion to the House.

Helen Whately: I welcome this chance to come to the House and speak about everything that we are doing right now, in the months ahead and for the longer term, so that people can get the healthcare they  need from our health and social care system at a time when it is under huge pressure—when we face the worst year for flu for a decade, with 100 times as many patients in hospital with flu as there were a year ago; when the NHS is working through the backlogs caused by our fight with covid; and when we know that the NHS is struggling with the high number of people coming to emergency departments and the difficulty of discharging people to be cared for at home.
These issues are mirrored in health systems across Europe, and indeed across the rest of the United Kingdom. Despite what Opposition Members are saying, the honest truth is that there are no silver bullets. I know that NHS and social care staff are working incredibly hard in the face of these challenges; I want to assure them, and everyone, that the Government are working flat out on short and long-term solutions to these great challenges. That work is supported with record NHS funding, rising further to £165 billion by 2025, and with more funding for social care, with the record increase of up to £7.5 billion over the next two years that we announced at the autumn statement. We have committed to getting waiting lists down and getting people the care they need more quickly, and we will do so.
I thank hon. Members for their contributions to the debate. I particularly thank those who have been constructive and thoughtful this afternoon. The Chair of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine), spoke about increased demand for care and the importance of prevention. My hon. Friend the Member for Erewash (Maggie Throup) brought in her expertise as a biomedical scientist when she talked about the potential for innovative diagnostic tests to improve care and productivity. My hon. Friend the Member for Peterborough (Paul Bristow) shared the story of how the life of a constituent was saved through first aid and brilliant NHS care.
We heard from my hon. Friend the Member for Southend West (Anna Firth), who works incredibly hard to support her hospital and who often comes to me with suggestions. My hon. Friend the Member for Bosworth (Dr Evans), who brings expertise as a doctor, spoke about the 50% increase in the number of people over 100 in the last decades. He talked about the increased demand for healthcare and brought in many ideas for what more we can do to increase healthcare supply. My hon. Friend the Member for Don Valley (Nick Fletcher) reminded us of some of the excellent care that the NHS is providing in his area. He also asked for a new hospital.
My right hon. Friend the Member for Wokingham (John Redwood) spoke about workforce and bed capacity. My hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell) spoke about the context of what we face, the extra flu admissions at Royal Stoke University Hospital and covid. My hon. Friend the Member for Devizes (Danny Kruger) spoke about the importance of integration in health and social care.
There are three more hon. Members I want to mention—I am sure they know who they are—because they represent constituents in Wales. They are all Conservatives; nobody is on the Opposition Benches representing Welsh constituencies today. Nobody here is standing up for Labour’s record in Wales. My right hon. Friend the Member for Vale of Glamorgan (Alun Cairns), my hon. Friend the Member for Clwyd South (Simon Baynes) and my hon. Friend the Member  for Aberconwy (Robin Millar) all reminded us of Labour’s shocking record of running the NHS in Wales. They spoke about more patients waiting over two years for treatment in Wales than in England, about a higher treatable mortality rate, and about the fact that it was not the Conservatives but a Labour Government in Wales who cut health spending. That is a record that no Labour Member has proved willing to defend.
Let me now respond to some of the criticisms from Opposition Members, starting with the way in which the NHS prepared for this winter. Back in August the NHS published its winter plan, which included proposals to increase capacity by 7,000 beds and increase the use of virtual wards, to ramp the number of staff to handle calls, and to establish system control centres in each of the 42 integrated care systems: that was delivered in December. We gave more than 17 million people a covid booster vaccine, and gave more than 19 million their flu jabs. The shadow Secretary of State is talking over me, but I recommend that he listen to what we have been doing.
We set up a national discharge taskforce to work with hospitals and the wider health and care system to improve flow in the system. We published “Our plan for patients”, which included a £500 million adult social care discharge fund that is being spent on more home and residential care packages and boosting the social care workforce to help get patients out of hospital—that is happening right now.
However, as we feared, the combined pressures of flu and covid, alongside unprecedented demand, have indeed left our health system facing enormous challenges this winter. That is precisely why, as my right hon. Friend the Secretary of State said in his statement on Monday, we are taking immediate further action to support the NHS and local authorities. We are providing £200 million of additional funding for short-term care placements to help patients to be discharged more quickly and safely from hospitals, and an extra £50 million in capital funding to expand hospital discharge lounges and ambulance hubs as a matter of urgency.
As we come out of this winter, we know that these problems will not suddenly disappear, and that is why we are already making plans for the future. For instance, we have six national “discharge frontrunners” leading the way in exploring new long-term initiatives to free up hospital beds. As was announced in the autumn statement, we will marry those new ideas with a further £600 million next year and £1 billion the year after in order to transform the way in which we handle discharges.
At the same time as putting in money here and now, we have plans in place which will transform our health and social care system over the next decade. Our integrated care systems are bringing together health and social care in a way that has never been seen before. Our NHS workforce plan will provide a long-term staffing plan for the next 15 years. We are bringing forward ambitious social care reforms, including workforce reforms to develop social care as a career. Our reforms are timely, ambitious and deliverable, developed in partnership with health and social care organisations, unlike Labour’s new plan for primary care, an expensive top-down reorganisation, uncosted and unfunded, and described by the chief executive of the Nuffield Trust as costing “a fortune” and “out of date”—like the Labour party.
Our health system, like others across Europe, is facing a multitude of pressures. We are taking action, in the short, medium and long term, to tackle each and every one of those pressures, and I am determined to ensure that the work we are doing will make things better not only in the here and now, but next winter, next year, and every year thereafter.
Question put (Standing Order No. 31(2)), That the original words stand part of the Question.

The House divided: Ayes 176, Noes 296.
Question accordingly negatived.
Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.

The House divided: Ayes 289, Noes 0.
Question accordingly agreed to.
The Deputy Speaker declared the main Question, as amended, to be agreed to (Standing Order No. 31(2)).
Resolved,
That this House pays tribute to the work done by the National Health Service and recognises that there are pressures on health systems around the world; recognises that all parts of the UK are  facing pressures; welcomes that the Government has committed to reduce waiting times in England as part of its strategy to strengthen the NHS and care system with up to £14.1 billion additional funding being made available by government over the next two years to improve urgent and emergency care and tackle the backlog—the highest spend on health and care in any government’s history; and regrets that the Scottish and Welsh governments have refused to make similar such commitments.

Business without Debate

Delegated Legislation

Motion made, and Question put forthwith (Standing Order No. 118(6)),

National Health Service

That the draft National Health Service (NHS Payment Scheme – Consultation) (No. 2) Regulations 2022, which were laid before this House on 16 November, be approved.—(Andrew Stephenson.)
Question agreed to.
Motion made, and Question put forthwith (Standing Order No. 118(6)),

Energy

That the Energy Bill Relief Scheme Pass-through Requirement (Heat Suppliers) (Amendment) Regulations 2022 (S.I., 2022, No. 1280), dated 5 December 2022, a copy of which was laid before this House on 6 December, be approved.—(Andrew Stephenson.)
Question agreed to.
Motion made, and Question put forthwith (Standing Order No. 118(6)),

Pensions

That the draft Pensions Appeal Tribunals (Late Appeal) (Amendment) Regulations 2022, which were laid before this House on 17 November, be approved.—(Andrew Stephenson.)
Question agreed to.
Motion made, and Question put forthwith (Standing Order No. 118(6)),

international Immunities and Privileges

That the draft State Immunity Act 1978 (Remedial) Order 2022, which was laid before this House on 7 September, be approved.—(Andrew Stephenson.)
Question agreed to.

Pokesdown Railway Station

Motion made, and Question proposed, That this House do now adjourn.—(Andrew Stephenson.)

Tobias Ellwood: I am sure colleagues will be delighted to stay to listen to this Adjournment debate on the upgrade of Pokesdown for Boscombe railway station—to give it its full name.
To place the area and the issue in context, Bournemouth is a relatively new town, founded just over 200 years ago and sitting between the ancient towns of Poole and Christchurch, both named in the Domesday Book. The latter part of the 19th century saw this beautiful stretch of the southern coastline become a popular place to live, work and visit, thanks largely to the new railway line, which was run in those days by the London and South Western Railway.
In those Victorian days, Boscombe certainly hogged the wicket, with grand hotels, theatres, music halls, its own football club, Boscombe—now better known as Athletic Football Club Bournemouth—and spas that rivalled that found in Bath, attracting the wealthiest in society to the coastline. They even prompted Sir Percy Florence Shelley, son of the novelist Mary Shelley, to buy an estate in this area for his mother, who is now buried in St Peter’s Church.
In the 1880s, both Boscombe and Pokesdown had their own railway stops on the London to Weymouth line, but, as Bournemouth’s population and popularity grew in size and status, it progressively took over as the focus of the conurbation. The decline in the traditional English holiday in the 1970s and ’80s was also tough on an area that had come to lean so heavily on domestic tourism.
Today, however, investments in the communities of Boscombe and Pokesdown are seeing a rejuvenation in its fortunes—pioneered thanks to the local council’s master plan, with the towns fund, to upgrade shopping centres, pedestrian areas and park space, improve modern housing, transform the seafront attractions and revitalise local transport schemes. That is helped, of course, by the success of AFC Bournemouth, our wonderful football club.
That brings me nicely to Pokesdown railway station, for the one piece of the jigsaw that has not kept up with this welcome renaissance is local transport infrastructure. In the time that I have been campaigning to upgrade the Boscombe railway station, Bournemouth’s mainline railway station, which many colleagues will have visited in the past because of conferences, has received not just a lick of paint, but an entire redesign. To be clear, I very much welcome that, but my concern is why, when there are similar plans for Pokesdown station, they are not being acted on.
Let me first describe the station. There is no way of dodging this: it is less than welcoming—indeed, it is pretty grim. The line is a cutaway, so while the station entrances are on ground level, the platforms are 20 m below, so that natural light is limited. There are no staff at the station, its ticket counters are automated and for decades the lifts have sat dormant, broken and rusting away. First impressions count, and anyone visiting Pokesdown for Boscombe station for the first time will not be impressed by the state of it.
In preparation for this debate, I have been looking through my old notes on the matter. I began lobbying to improve the station back in 2016, and in fact I have a Department of Transport letter dated 26 May 2016 from the railways Minister at the time, Claire Perry—she has been in the news recently, although not because of my railway station. Each time I have met another Transport Minister, the same story applies: plans are in progress, tenders are being lined up, work will start soon. I really hope that that is not the generic message that I will hear from the Minister today.
It is really not complicated; we are not redesigning Waterloo or building a brand-new station. The stakeholders involved here are the local council, South Western Railway, Network Rail and the Department for Transport. I have held individual meetings and collective Zoom conference calls to try to nudge this project forward. I and the local community originally wanted the lifts, which had been broken for 35 years, to be improved—that is all. We had some passionate public meetings. Families with babies and toddlers who use prams, pushchairs, buggies and strollers want step-free access to the platforms. Those in wheelchairs do not want to have to disembark at Bournemouth station and trek back in a taxi. There are many elderly residents who are mobile but may find the 44 steps a challenge.
The money is there—I have lobbied for it. Bournemouth, Christchurch and Poole Council has pledged £2.6 million, and South Western Railway and Network Rail have committed £3.1 million, providing a total of £5.7 million. The Department for Transport has approved the plans, so the £5.7 million question is, “Why has the work not started?”
I accept that the project has grown. It became clear that funds were available not only to repair the lifts, but to repaint the station, modernise the forecourt and platform canopies, improve security and fencing, upgrade the footbridge and even introduce station wi-fi, and who would say no to that? Even AFC Bournemouth, whose ground is only a stone’s throw from the station, has offered to help to give the station some local personality by using its large football montages to brighten the platform. I had the pleasure of speaking with Jeff Mostyn, the former chairman and now ambassador of that club, who has been so supportive in the community. He is now equally baffled by why progress has not been made.
Seven years since I started lobbying a previous railways Minister, I ask this Minister, “Please, can we fix the lifts?” Almost half a million people now use Pokesdown for Boscombe railway station every year. In business, in hospitality and residential-wise, the area is now flourishing and growing. The money is in place, the council is on board, South Western Railway and Network Rail are committed, the community is fully behind this, as is our wonderful football club, so what are we waiting for?
I look forward to hearing what the Minister has to say. I hope that he will use this opportunity to confirm that committed funds for the station upgrade will be honoured; that tenders, contracts and plans have now been agreed and are in place; that there is now a fixed date for work to commence, with the lift replacements taking priority; and that he himself will be willing to visit my constituency on the date that work commences to make sure that it does actually start.
It is a real honour and privilege to represent Bournemouth East. It has been so encouraging to see Boscombe and Pokesdown rekindling and advancing their own identities as vibrant communities within the Bournemouth conurbation. So let us honour the promises to upgrade the railway station. Let us fix this problem, which has been neglected for so long. Let us finally get the job done.

Huw Merriman: I congratulate my right hon. Friend the Member for Bournemouth East (Mr Ellwood) on securing this debate on improvements at Pokesdown station. I have listened to all he has had to say to me and to my numerous predecessors on this matter, and I will endeavour to give him the reassurance that he seeks. I will be able to give him some timelines as well, and  I very much hope that we can be held to them and that, together, we can deliver all that he is asking for.
I will start by reassuring my right hon. Friend that £5.7 million of funding has been agreed, as he is aware, and is still there, as he was seeking to ensure. That money will go towards facilitating improvements at Pokesdown station. It has been jointly funded by Network Rail, South Western Railway and Bournemouth, Christchurch and Poole Council. All the funding has been provided to Network Rail so that the works can be carried out. They are essential works, as he rightly said. I also want to say how grateful I am to Bournemouth, Christchurch and Poole Council for providing, together with Network Rail and South Western Railway, the funds required to start these necessary improvements at Pokesdown station.
I am aware, and my right hon. Friend detailed it in his speech, that Boscombe has fabulous beaches, and that is the area where the station can be found, but there are pockets of deprivation within that area. I am aware, as an East Sussex coastal MP, that not all parts of our coast have the same level of comfort of having the services or, indeed, the populace that stations require. There are other stations that require regeneration, and I believe this may fit within that description. It is vital that we do everything we can to ensure that rail customers get accessibility and improved facilities, but also benefit from the lift that gives to the rest of the area. While much of the focus on levelling up has been on the north, I am aware that funding further south will also give those same opportunities to deliver improvements to the tangible benefit of rail users in the area.
My right hon. Friend certainly deserves an update on timescales and where we have got to, and I can give him that. We expect the canopies to be completed by mid-2023—so, by the middle of this year—and the footbridge by mid-2024 at the latest. On the lifts, Network Rail expects to award the tender for the outline design of the lifts by the end of this month. This stage of work is anticipated to be completed by July this year, at which point the design will be tendered to establish a detailed design and construction cost. Network Rail, in agreement with the train operator and the local council that has so generously assisted with funds, hopes to be able to award the construction contract, subject to the tender cost being within the budget, later this year. The actual construction timeframe will not be known to an accurate level until the detailed design is complete later in the year and suitable track possessions have been booked.

Tobias Ellwood: Will the Minister give way?

Huw Merriman: I thought that might elicit an intervention. I will happily take it.

Tobias Ellwood: First, may I just thank the Minister for clearly looking carefully at the details and confirming many of the things that I have requested? If I may, I would like to take this opportunity just to underline the importance of those lifts, because he has outlined a process, and it does seem that it is still taking some time to complete. I am pleased about the canopies and the footbridge, but what locals want most urgently is for the lifts to be completed. Is there anything he can do to expedite the tender process and the awarding of a contract to make sure that the work can commence as early as possible?

Huw Merriman: My right hon. Friend is absolutely right, and I listened in some detail to his point that this started with a request that lifts be working, then all of a sudden a lot more money was promised to the scheme. That is a positive, but within that it is taking an awfully long time to deliver, which means that the starting issue still remains. Having been put into post a few months ago, it is clear to me that there is a danger that we over-engineer projects and do not deliver the fix that the community has been seeking.
While I am pleased that the accessibility fund will have delivered 300 accessible stations by the end of next year, with improvements to more than 1,000 more stations—indeed, we have done an audit of all stations; that is 90% complete, and we will be publishing details in spring—I am absolutely dedicated to ensuring that where we have signed off projects, we get on with them.  We should not overcomplicate them, but make sure they are delivered, otherwise, for the years that they are not, people have missed out on those accessibility improvements. My right hon. Friend has that assurance from me, and indeed he has the assurance that I will follow this project and ensure that the timescales we give to this House are met or that there are good reasons why they are not.
My right hon. Friend referenced many of my predecessors, and I am grateful to them for recommending that the improvements take place. I am also grateful and want to pay tribute to him for the work he has done in securing additional funding from his local council to ensure that the scope will include lifts, canopy and footbridge. I recognise the frustration, as I hope has come across, in the length of time it has taken to get the project off the ground. I have referenced some of the reasons for that—we have had delays in securing the funding and finalising the overall scope of the project. However, I am now confident the scheme is on the right track towards delivery, and I will do everything I can to ensure that that takes place.
On that basis, I look forward to the whole project being completed by the end of 2024—having started much earlier than that, it can be delivered by 2024. I recognise my right hon. Friend’s frustration, and I am sorry for and regret the delays. I hope that I will be the rail Minister that works with him to ensure the completion of the project, and I very much look forward to coming down to visit Pokesdown station to see the benefits from this project for all rail users.
Question put and agreed to.
House adjourned.